Title | Cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic HIV practice in New York City. |
Publication Type | Journal Article |
Year of Publication | 2021 |
Authors | Siegler E, Moxley J, Mauer E, Glesby M |
Journal | BMJ Open |
Volume | 11 |
Issue | 8 |
Pagination | e047199 |
Date Published | 2021 08 11 |
ISSN | 2044-6055 |
Keywords | Comorbidity, Cross-Sectional Studies, Female, HIV Infections, Humans, Infant, Newborn, Middle Aged, Multimorbidity, New York City, Prevalence, Retrospective Studies |
Abstract | OBJECTIVES: People with HIV have high levels of multimorbidity, but studies often focus on high-risk comorbidities such as hypertension or coronary artery disease. We examined both high-risk and functional comorbidities in an ethnically diverse clinic population to compare the prevalence of comorbidities and different patterns of multimorbidity. DESIGN: Retrospective cross-sectional study. SETTING: University-based primary care HIV clinic with two locations in New York City. PARTICIPANTS: Patients who had been seen by a physician at least once between 1 June 2016 and 31 May 2017. PRIMARY AND SECONDARY OUTCOME MEASURES: Data regarding demographics, diagnoses and lab values were downloaded in a one-time data import from the electronic medical record. Comorbidities were classified as high-risk (with major impact on mortality) or functional (with major impact on function), and multimorbidity was determined for both classes in the total sample of 2751. Factors associated with high-risk and functional multimorbidity were determined first through bivariate analysis and then through multivariable median regression in 2013 patients with complete data. RESULTS: Median age was 52 years (IQR 43-59). Cisgendered women comprised 24.6% of the sample, and 31.7% were African-American. Both functional and high-risk comorbidities were common and risk increased with age. Among those 75 and older, median number of both functional and high-risk comorbidities was 3 (IQR 2-4). High-risk comorbidities were associated with age (p<0.001), more years with an HIV diagnosis (p<0.001) and being an African-American (p<0.001). Associated with a higher number of functional comorbidities were age (p<0.001), being a cisgender female (p<0.001), being Hispanic (p=0.01) and more years with an HIV diagnosis (p<0.001). CONCLUSIONS: Comorbidities with functional impact increase with age in parallel to those with a more direct impact on mortality and should be assessed and monitored, especially as the population with HIV ages. |
DOI | 10.1136/bmjopen-2020-047199 |
Alternate Journal | BMJ Open |
PubMed ID | 34380723 |