ArticleMedical care2014
Assessment of morbidity over time in predicting health outcomes.
Article in Medical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Current and historic patterns of chronic disease burden are associated with physical activity and sedentary behavior in older adults: an observational study.BMC public health · 2025Observational
- Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern.BMC public health · 2024Article
- 10-Year Multimorbidity Trajectories in Older People Have Limited Benefit in Predicting Short-Term Health Outcomes in Comparison to Standard Multimorbidity Thresholds: A Population-Based Study.Clinical epidemiology · 2024Article
- Physical Activity as a Mediator Between Race/Ethnicity and Changes in Multimorbidity.The journals of gerontology. Series B, Psychological sciences and social sciences · 2022Article
- Studying trajectories of multimorbidity: a systematic scoping review of longitudinal approaches and evidence.BMJ open · 2021Article
- Long-term mortality in young and middle-aged adults hospitalised with chronic disease: a Danish cohort study.BMJ open · 2020Article
- Toolkit to Compute Time-Based Elixhauser Comorbidity Indices and Extension to Common Data Models.Healthcare informatics research · 2020Article
- Harnessing repeated measurements of predictor variables for clinical risk prediction: a review of existing methods.Diagnostic and prognostic research · 2020Review
- Relationship between multimorbidity, demographic factors and mortality: findings from the UK Biobank cohort.BMC medicine · 2019Article
- Development and validation of QMortality risk prediction algorithm to estimate short term risk of death and assess frailty: cohort study.BMJ (Clinical research ed.) · 2017Article
- Article
- Comparison of Comorbidity Scores in Predicting Surgical Outcomes.Medical care · 2016Article
- Meeting the needs of a complex population: a functional health- and patient-centered approach to managing multimorbidity.Journal of comorbidity · 2016Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundAdministratively derived morbidity measures are often used in observational studies as predictors of outcomes. These typically reflect a limited time period before an index event; some outcomes may be affected by rate of morbidity change over longer preindex periods.
objectivesThe aim of the study was to develop statistical models representing the trajectory of individual morbidity over time and to evaluate the performance of trajectory versus other summary morbidity measures in predicting a range of health outcomes.
methodsFrom a retrospective cohort study of integrated health system members aged 65 years or older with 3 or more common chronic medical conditions, we used available diagnoses for up to 10 years to examine associations between variations of the Charlson Comorbidity Index (CCI, Quan adaptation) and health outcomes. A linear mixed effects model was used to estimate the trajectory of individual CCI over time; estimated parameters describing individual trajectories were used as predictors for health outcomes. Other variations of CCI were: a "snapshot" measure, a cumulative measure, and actual baseline and rate of change. Models were developed in an initial cohort for whom we had survey data, and verified in a larger cohort.
resultsAmong 961 surveyed members and 13,163 members of a secondary cohort, cumulative and snapshot measures provided best fit and predictive ability for utilization outcomes. Incorporating trajectory resulted in a slightly better model for self-reported health status.
conclusionsModeling longitudinal morbidity trajectories did not add substantially to the association between morbidity and utilization or mortality. Standard snapshot morbidity measures likely sufficiently capture multimorbidity in assessing these outcomes.
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Registered trials
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