University of Massachusetts Medical School Faculty Publications
Title
Multiple Chronic Conditions and Psychosocial Limitations in Patients Hospitalized with an Acute Coronary Syndrome
UMMS Affiliation
Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine; Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine
Publication Date
12-20-2015
Document Type
Article
Disciplines
Cardiology | Cardiovascular Diseases | Geriatrics
Abstract
BACKGROUND: As adults live longer, multiple chronic conditions have become more prevalent over the past several decades. We describe the prevalence of, and patient characteristics associated with, cardiac and non-cardiac-related multimorbidities in patients discharged from the hospital after an acute coronary syndrome.
METHODS: We studied 2,174 patients discharged from the hospital after an acute coronary syndrome at 6 medical centers in Massachusetts and Georgia between April, 2011 and May, 2013. Hospital medical records yielded clinical information including presence of 8 cardiac-related and 8 non-cardiac-related morbidities on admission. We assessed multiple psychosocial characteristics during the index hospitalization using standardized in-person instruments.
RESULTS: The mean age of the study sample was 61 years, 67% were men, and 81% were non-Hispanic whites. The most common cardiac-related morbidities were hypertension, hyperlipidemia, and diabetes (76%, 69%, and 31%, respectively). Arthritis, chronic pulmonary disease, and depression (20%, 18%, and 13%, respectively) were the most common non-cardiac morbidities. Patients with ≥4 morbidities (37% of the population) were slightly older and more frequently female than those with 0-1 morbidity; they were also heavier and more likely to be cognitively impaired (26% vs. 12%), have symptoms of moderate/severe depression (31% vs. 15%), high perceived stress (48% vs. 32%), a limited social network (22% vs. 15%), low health literacy (42% vs. 31%), and low health numeracy (54% vs. 42%).
CONCLUSIONS: Multimorbidity, highly prevalent in patients hospitalized with an acute coronary syndrome, is strongly associated with indices of psychosocial deprivation. This emphasizes the challenge of caring for these patients, which extends well beyond acute coronary syndrome management.
Keywords
UMCCTS funding
DOI of Published Version
10.1016/j.amjmed.2015.11.029
Source
Tisminetzky M, Gurwitz J, McManus DD, Saczynski JS, Erskine N, Waring ME, Anatchkova M, Awad H, Parish DC, Lessard D, Kiefe C, Goldberg R. Multiple Chronic Conditions and Psychosocial Limitations in Patients Hospitalized with an Acute Coronary Syndrome. Am J Med. 2015 Dec 20. pii: S0002-9343(15)30028-0. doi:10.1016/j.amjmed.2015.11.029. [Epub ahead of print] PubMed PMID: 26714211. Link to article on publisher's website
Related Resources
Journal/Book/Conference Title
The American journal of medicine
PubMed ID
26714211
Repository Citation
Tisminetzky, Mayra; Gurwitz, Jerry H.; McManus, David D.; Saczynski, Jane S.; Erskine, Nathaniel; Waring, Molly E.; Anatchkova, Milena D.; Awad, Hamza H.; Parish, David C.; Lessard, Darleen M.; Kiefe, Catarina I.; and Goldberg, Robert J., "Multiple Chronic Conditions and Psychosocial Limitations in Patients Hospitalized with an Acute Coronary Syndrome" (2015). University of Massachusetts Medical School Faculty Publications. 851.
https://escholarship.umassmed.edu/faculty_pubs/851