Observational studyBMJ open2019
Multimorbidity patterns in patients with heart failure: an observational Spanish study based on electronic health records.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
What it found
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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.
The trial behind it
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Who cites it
30 citing papers in PubMed, 50 citations in OpenAlex.
- Skilled Nursing Facility-to-Home Transitions After Heart Failure Hospitalization: A Mixed-Methods Study of Communication, Self-Care, Medication, and Follow-Up.Circulation. Heart failure · 2026Article
- Comorbidity Clusters in Acute Heart Failure: Insights From the AMERICCAASS Registry.Journal of the American Heart Association · 2026Observational
- Gender Differences in Disease Burden, Symptom Burden, and Quality of Life Among People Living With Heart Failure and Multimorbidity: Cross-Sectional Study.Journal of advanced nursing · 2026Article
- Temporal Prognostic Factors in Elderly Patients with Acute Heart Failure: A Cohort Study from a Spanish Emergency Department.Geriatrics (Basel, Switzerland) · 2026Article
- Comorbidity Patterns in Patients with First-Ever Acute Ischemic Stroke and Their Associations with Functional Outcomes.Neuroepidemiology · 2026Article
- Co-Occurring Diseases and Mortality in Patients With Chronic Heart Disease, Modeling Their Dynamically Expanding Disease Portfolios: Nationwide Register Study.JMIR cardio · 2025Article
- Prevalence, patterns of multimorbidity, and its correlations with health-related quality of life in rural southwest China: a cross-sectional study.Frontiers in medicine · 2025Article
- Disease Network-Based Approaches to Study Comorbidity in Heart Failure: Current State and Future Perspectives.Current heart failure reports · 2024Review
- Exploring the Association Between Heart Rate Control and Rehospitalization: A Real-World Analysis of Patients Hospitalized with Heart Failure with Reduced Ejection Fraction.Drugs - real world outcomes · 2024Article
- Profile and Prognostic Impact of Multimorbidity in Elderly Patients with Heart Failure: Are there Differences between Men and Women?Current heart failure reports · 2024Review
- Multimorbidity in Incident Heart Failure: Characterisation and Impact on 1-Year Outcomes.Journal of clinical medicine · 2024Article
- Identifying subgroups in heart failure patients with multimorbidity by clustering and network analysis.BMC medical informatics and decision making · 2024Article
- Sex differences in clinical characteristics and long-term outcome in patients with heart failure: data from the KorAHF registry.The Korean journal of internal medicine · 2024Article
- Heart Failure and Multimorbidity in Asia.Current heart failure reports · 2023Review
- Needs of multimorbid heart failure patients and their carers: a qualitative interview study and the creation of personas as a basis for a blended collaborative care intervention.Frontiers in cardiovascular medicine · 2023Article
- Longitudinal models for the progression of disease portfolios in a nationwide chronic heart disease population.PloS one · 2023Article
- Polypharmacy Patterns in Multimorbid Older People with Cardiovascular Disease: Longitudinal Study.Geriatrics (Basel, Switzerland) · 2022Article
- Epidemiological and Clinical Features in Very Old Men and Women (≥80 Years) Hospitalized with Aortic Stenosis in Spain, 2016-2019: Results from the Spanish Hospital Discharge Database.Journal of clinical medicine · 2022Article
- Multimorbidity patterns and the relation to self-rated health among older Japanese people: a nationwide cross-sectional study.BMJ open · 2022Article
- Observational
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo characterise the comorbidities of heart failure (HF) in men and women, to explore their clustering into multimorbidity patterns, and to measure the impact of such patterns on the risk of hospitalisation and mortality.
designObservational retrospective population study based on electronic health records.
settingEpiChron Cohort (Aragón, Spain).
participantsAll the primary and hospital care patients of the EpiChron Cohort with a diagnosis of HF on 1 January 2011 (ie, 8488 women and 6182 men). We analysed all the chronic diseases registered in patients' electronic health records until 31 December 2011. PRIMARY OUTCOME: We performed an exploratory factor analysis to identify the multimorbidity patterns in men and women, and logistic and Cox proportional-hazards regressions to investigate the association between the patterns and the risk of hospitalisation in 2012, and of 3-year mortality.
resultsAlmost all HF patients (98%) had multimorbidity, with an average of 7.8 chronic diseases per patient. We identified six different multimorbidity patterns, named cardiovascular, neurovascular, coronary, metabolic, degenerative and respiratory. The most prevalent were the degenerative (64.0%) and cardiovascular (29.9%) patterns in women, and the metabolic (49.3%) and cardiovascular (43.2%) patterns in men. Every pattern was associated with higher hospitalisation risks; and the cardiovascular, neurovascular and respiratory patterns significantly increased the likelihood of 3-year mortality.
conclusionsMultimorbidity is the norm rather than the exception in patients with heart failure, whose comorbidities tend to cluster together beyond simple chance in the form of multimorbidity patterns that have different impact on health outcomes. This knowledge could be useful to better understand common pathophysiological pathways underlying this condition and its comorbidities, and the factors influencing the prognosis of men and women with HF. Further large scale longitudinal studies are encouraged to confirm the existence of these patterns as well as their differential impact on health outcomes.
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