Evidence map›Paper›PMID 30246862›Full record

ArticleJournal of the American Geriatrics Society2018

Multimorbidity Burden and Adverse Outcomes in a Community-Based Cohort of Adults with Heart Failure.

Mayra Tisminetzky, Jerry H Gurwitz, Dongjie Fan, Kristi Reynolds, David H Smith, David J Magid, Sue Hee Sung, Terrence E Murphy, Robert J Goldberg, Alan S Go

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Prevalence and prognosis of multimorbidity in heart failure with mildly reduced ejection fraction.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mayra TisminetzkyMeyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester, Massachusetts.
Jerry H GurwitzMeyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester, Massachusetts.
Dongjie FanDivision of Research, Kaiser Permanente Northern California, Oakland, California.
Kristi ReynoldsDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
David H SmithCenter for Health Research, Kaiser Permanente Northwest, Oregon, Portland.
David J MagidThe Kaiser Institute for Health Research Denver, Denver, Colorado.
Sue Hee SungDivision of Research, Kaiser Permanente Northern California, Oakland, California.
Terrence E MurphySection of Geriatrics, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut.
Robert J GoldbergMeyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester, Massachusetts.
Alan S GoDivision of Research, Kaiser Permanente Northern California, Oakland, California.

Funding

Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Denise Esserman · 2002 to 2026
$37.9M
HMO Research Network Cardiovascular Research NetworkU19HL091179 · NHLBI · KAISER FOUNDATION RESEARCH INSTITUTE · PI GO, ALAN S · 2007 to 2011
$8.7M
Advancing Geriatrics Infrastructure & Network Growth - Admin Supplement: Designing and Testing an Informatics Tool to Aid Prescribers in Reducing Anticholinergic Burden in Older AdultsR24AG045050 · NIA · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI GURWITZ, JERRY H · 2014 to 2017
$3.6M
Management and Outcomes of Heart Failure with Preserved Systolic FunctionRC1HL099395 · NHLBI · KAISER FOUNDATION RESEARCH INSTITUTE · PI GO, ALAN S · 2009 to 2010
$1000k
NHLBI NIH HHS RC1 HL099395NHLBI NIH HHS RC1 HL099395 U19 HL91179NHLBI NIH HHS U19 HL091179NIA NIH HHS P30 AG021342NIA NIH HHS R24 AG045050Yale Claude D. Pepper Older Americans Independence Center P30AG021342
6 · The paper itself

Abstract

objectivesTo assess multimorbidity burden and its association with clinical outcomes in adults with heart failure (HF) according to sex, age, and HF type.

designRetrospective cohort study.

settingFive healthcare delivery systems across the United States.

participantsAdults with HF (N=114,553). MEASUREMENTS: We characterized participants with respect to the presence of 26 chronic conditions categorized into quartiles based on overall burden of comorbidity (<5, 5-6, 7-8, ≥9). Outcomes included all-cause death and hospitalization for HF or any cause. Multivariable Cox regression was used to evaluate the adjusted association between categorized burden of multimorbidity burden and outcomes.

resultsIndividuals with more morbidities were more likely to die than those with fewer then 5 morbidities (5-6 morbidities: adjusted hazard ratio (aHR)=1.27 (95% confidence interval (CI)=1.24-1.31; 7-8 morbidities: aHR=1.52, 95% CI=1.48-1.57; ≥9 morbidities: aHR=1.92, 95% CI=1.86-1.99). There was a graded, higher adjusted rate of any-cause hospitalization associated with 5 or 6 (aHR=1.28, 95% CI=1.25-1.30), 7 or 8 (aHR=1.47, 95% CI=1.44-1.50), or 9 or more (aHR=1.77, 95% CI=1.73-1.82) morbidities (vs <5). Similar findings were observed for HF-specific hospitalization in those with 5 or 6 (aHR=1.22, 95% CI=1.19-1.26), 7 or 8 (aHR=1.39, 95% CI=1.34-1.44), or 9 or more (aHR 1.68, 95% CI=1.61-1.74) morbidities (vs <5). Consistent findings were seen according to sex, age group, and HF type (preserved, reduced, borderline HF), in the association between categorical burden of multimorbidity and outcomes especially prominent in individuals younger than 65.

conclusionAfter adjustment, higher levels of multimorbidity predicted worse HF outcomes and may be an important consideration in strategies to improve clinical and person-centered outcomes. J Am Geriatr Soc 66:2305-2313, 2018.

Indexed as

Chronic DiseaseIndependent LivingAgedCause of DeathFemaleHeart FailureHospitalizationHumansMaleMultimorbidityRetrospective StudiesUnited Statescomorbidityheart failuremultimorbiditymultiple chronic conditions

Identifiers

PMID30246862
PMCPMC6697073

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.