Features of modern polymorbidity internal medicine
Author Affiliations1Center of Clinical and Experimental Medicine of SB RAMS, 630117 Novosibirsk, Timakov str., 2
2Center of Clinical and Experimental Medicine of SB RAMS, 630117 Novosibirsk, Timakov str., 2
3Novosibirsk State Medical University of Miszdrav of Russia 630091, Novosibirsk, Krasny av., 52
4Center of Clinical and Experimental Medicine of SB RAMS, 630117 Novosibirsk, Timakov str., 2
5Center of Clinical and Experimental Medicine of SB RAMS, 630117 Novosibirsk, Timakov str., 2
Abstract
The analysis of the occurrence dynamics of trans-nosologic and trans-system polymorbidity in the general therapeutic clinic over a period of 2003-2011 years has been carried out. 23310 patients (9111 males and 14199 females) underwent medical treatment in the Clinic of Scientific Center for Clinical and Experimental Medicine of SB RAMS were the object of the study. Polymorbidity indicators in men and women were assessed. The estimate was carried out both in the whole category of patients and in three age periods: 16-39 years, 40-59 years and above 60 years. It has been shown that the average number of nosological forms (trans-nosologic polymorbidity) of the patients was equal to 4,5 ± 0,01, and the cases of system pathology (trans-system polymorbidity) - 3,76 ± 0,01. In men, these indicators were 4,88 ± 0,02 and 3,92 ± 0,02, and in women 5,33 ± 0,02 and 4,19 ± 0,01 - respectively were significantly higher than in male persons. In the period from 2003 to 2011 years rapid increase both in trans-nosologic and trans-system polymorbidity was revealed, the value of which per patient on average six clinical entities have reached and exceeded four concerned the physiological systems. Coefficient of trans-nosologic and trans-system polymorbidity has gender differences. In women, it has a higher value compared to men. In the period from 2003 to 2011 the incidence of isolated forms of cardio-vascular system reduced and the value of their syntropy with the diseases of the digestive system increased.
Key words
References1. Belyalov F.I. Treatment of internal diseases in the context of comorbidity. Irkutsk, 2013 . 296. (In Russian)
2. Belyalov F.I. Comorbidity. http://therapy.irkutsk.ru/edcomorbid.htm. (In Russian)
3. Ivashova S.S. Prevalence of non-infectious diseases risk factors among unorganized population of industrial city under conditions of the North. Correction possibilities. Kardiovaskulyarnaya terapiya i profilaktika. 2009. (S). 133a–133. (In Russian)
4. Lazebnik L.B. Aging and polymorbidity. Konsilium Medikum. 2005. 12. http://old.consilium-medicum.com/media/consilium/05_12/993.shtml (In Russian)
5. Lazebnik L.B. Polymorbidity and aging. Novosti meditsiny i farmatsyei. 2007. (1). http://www.mif-ua.com/archive/article/3531. (In Russian)
6. Mitrofanov I.M., Selyatitskaya V.G., Nikolaev Yu.A., Lutov Yu.V. Prevalence of metabolic syndrome in organized population. Klinich. med. 2012. 90. (11). 47–50. (In Russian)
7. Mitrofanov I.M., Nikolaev Yu.A., Dolgova N.A., Pospelova T.I. Regional peculiarities of polymorbidity in current clinics of internal diseases. Klinich. med. 2013. 91. (6). 26–29 (In Russian)
8. Nikolaev Yu.A., Shkurupy V.A., Mitrofanov I.M., Polyakov V.Ya. Dynamic of prevalence of combined chronic non-infectious diseases in working people of Mirny city of Sakha Republic (Yakutiya). Byul. SO RAMN. 2012. 32. (5). 69–74. (In Russian)
9. Smirnova L.E Toward the problem of comorbidity of ulcerous erosive damages of gastro-duodenal zone and arterial hypertension. Klinich. med. 2003. (3). 9–15. (In Russian)
10. Bhaskaran K., Hajat S., Haines A. et al. Short term effects of temperature on risk of myocardial infarction in England and Wales: time series regression analysis of the Myocardial Ischemia National Audit Project (MINAP) registry // BMJ. 2010. (341). 3823.
11. Boyd J.H., Burke J.D. Exclusion criteria of DSM-III: a study of co-occurrence of hierarchy-free syndromes // Arch. Gen. Psychiatry. 1984. 41. 983–989.
12. Caughey 10G.E., Vitry A.I., Gilbert A.L., Roughead E.E. Prevalence of comorbidity of chronic diseases in Australia // BMC Public Health. 2008. 8. 221.
13. Feinstein 1A.R. Pre-therapeutic classification of co-morbidity in chronic disease // J. Chronic Dis. 1970. 23. (7). 455–468.
14. Rijken 15M., Kerkhof M., Dekker J., Schellevis F. Comorbidity of chronic diseases: effects of disease pairs on physical and mental functioning // Qual. Life Res. 2005. (4). 45–55.
Schellevis 5F.G., van der Velden J., van de Lisdonk E. et al. Comorbidity of chronic diseases in general practice // J. Clin. Epidemiol. 1993. 46. 469–473.
15. Schellevis 5F.G., van der Velden J., van de Lisdonk E. et al. Comorbidity of chronic diseases in general practice // J. Clin. Epidemiol. 1993. 46. 469–473.
About Authors (Correspondence):
Nikolaev Yu.A. - doctor of medical sciences, head of the laboratory for pathogenesis of somatic diseases, chief researcher, e-mail: nicol@soramn.ru
Mitrofanov I.M. - doctor of medical sciences, leading researcher of the laboratory for pathogenesis of somatic diseases, chief researcher, e-mail: mim@soramn.ru
Pospelova T.I. - doctor of medical sciences, professor, head of the chair for therapy, hematology and transphysiology, e-mail: postatgem@mail.ru
Dolgova N.A. - head physician
Polyakov V.Ya. - candidate of medical sciences, senior researcher, e-mail: vpolyakov15@yandex.ru
Full Text