Evidence map›Paper›PMID 40181322›Full record

ArticleBMC public health2025

Multimorbidity patterns and premature mortality in a prospective cohort: effect modifications by socioeconomic status and healthy lifestyles.

Qingping Xue, Shanshan Zhang, Xue Yang, Yan-Bo Zhang, Yidan Dong, Fan Li, Shuo Li, Nianwei Wu, Tong Yan, Ying Wen and 5 more

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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

  1. Pooled it
  2. Article
  3. Article
  4. Review
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

15 authors.

Qingping XueDepartment of Epidemiology and Health Statistics, School of Public Health, Chengdu Medical College, Chengdu, Sichuan, China.
Shanshan ZhangSection of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & Children's Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University, 3-17 Renmin Nanlu, Chengdu, 610041, Sichuan, China.
Xue YangCenter for Immunological and Metabolic Diseases, MED-X Institute, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Yan-Bo ZhangDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Yidan DongSection of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & Children's Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University, 3-17 Renmin Nanlu, Chengdu, 610041, Sichuan, China.
Fan LiSection of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & Children's Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University, 3-17 Renmin Nanlu, Chengdu, 610041, Sichuan, China.
Shuo LiSection of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & Children's Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University, 3-17 Renmin Nanlu, Chengdu, 610041, Sichuan, China.
Nianwei WuSection of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & Children's Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University, 3-17 Renmin Nanlu, Chengdu, 610041, Sichuan, China.
Tong YanCenter for Obesity and Metabolic Health & Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu & The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China.
Ying WenShenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China.
Chun-Xia YangDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Jason Hy WuThe George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
An PanDepartment of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Yunhaonan Yang *Section of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & Children's Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University, 3-17 Renmin Nanlu, Chengdu, 610041, Sichuan, China. yunhaonanyang@scu.edu.cn.
Xiong-Fei Pan *Section of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & Children's Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University, 3-17 Renmin Nanlu, Chengdu, 610041, Sichuan, China. pxiongfei@scu.edu.cn.ORCID http://orcid.org/0000-0002-9350-9230

Funding

the CMC Excellent-talent Program 2024qnGzn17the Fundamental Research Funds for the Central Universities YJ202346the National Natural Science Foundation of China 72204031
6 · The paper itself

Abstract

backgroundFew studies have explored the impact of multimorbidity patterns on premature mortality. This study aimed to assess the associations between multimorbidity patterns and long-term mortality and whether the associations were modified by socioeconomic status (SES) and healthy lifestyles.

methodsData were from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 in the US. The latent class analysis was used to establish multimorbidity patterns based on 11 chronic conditions. Mortality outcomes were ascertained by linking with the public-use mortality data from the National Death Index through December 31, 2019. Accelerated failure time models were used to estimate time ratios (TRs) and corresponding 95% confidence intervals (CIs) for the associations between multimorbidity patterns and all-cause and CVD mortality and to exmine the extent to which SES and healthy lifestyles modified those associations.

resultsIn our study, six multimorbidity patterns were identified, including "relatively healthy", "hypercholesterolemia", "metabolic", "arthritis-respiratory", "CKD-vascular-cancer", and "severely impaired" classes. Compared with the "relatively healthy" class, TRs for all-cause and CVD mortality progressively decreased across the multimorbidity classes, with the "severely impaired" class showing the shortest survival time (TR, 0.53; 95% CI: 0.48, 0.58 for all-cause mortality; 0.42; 0.35, 0.50 for CVD mortality). A significant interaction was noted between SES and multimorbidity patterns for survival time, with a stronger positive association in individuals with low SES. Adherence to healthy lifestyles was related to longer survival time across all multimorbidity patterns, especially in those with relatively less severe multimorbidity.

conclusionsMultiple multimorbidity patterns were identified and associated with mortality. Lower SES was associated with higherexcess multimorbidity-associated mortality, while adopting healthy lifestyles contributed to longer survival regardless of multimorbidity patterns. Efforts should be mobilized to reduce SES gaps and promote healthy lifestyles to alleviate the health burden of multimorbidity.

Indexed as

Healthy LifestyleMortality, PrematureMultimorbiditySocial ClassAdultAgedCardiovascular DiseasesChronic DiseaseFemaleHumansMaleMiddle AgedNutrition SurveysProspective StudiesUnited StatesCohort studyHealthy lifestylesMortalityMultimorbiditySocioeconomic status

Identifiers

PMID40181322
PMCPMC11969841

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.