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Holm NN, Frølich A, Dominguez H, Dalhoff K, Juul-Larsen HG, Andersen O, Stockmarr A
Co-Occurring Diseases and Mortality in Patients With Chronic Heart Disease, Modeling Their Dynamically Expanding Disease Portfolios: Nationwide Register Study
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Co-occurring diseases and mortality in patients with chronic heart disease modelling their dynamically expanding disease portfolio: A nationwide register study
Nikolaj Normann Holm;
Anne Frølich;
Helena Dominguez;
Kim Dalhoff;
Helle Gybel Juul-Larsen;
Ove Andersen;
Anders Stockmarr
ABSTRACT
Medical advances in managing chronic heart disease patients permit co-occurrence of other diseases due to increased longevity. Existing models on the effect of co-occurring diseases on mortality often consider disease counts or clusters at baseline, overlooking the dynamic development of patients’ disease portfolios over time. In this study, encompassing electronic health record data of all 766,596 adult heart disease patients in Denmark (1995-2015), we identified interactions among co-occurring diseases, analyzing their impact on time until death. Cancer had highest mortality impact (hazard ratio (HR) 6.72 males, 7.59 females). Excluding cancer highlighted schizophrenia and dementia with highest mortality impact (top five HRs in range 11.72-13.37 males, 13.86-16.65 females, for combinations of four diseases). An additive model underestimated the effects by a factor of 1.4 compared to the interaction model. These findings emphasize the importance of modelling disease interactions for a comprehensive understanding of mortality risk in heart disease patients.
Citation
Please cite as:
Holm NN, Frølich A, Dominguez H, Dalhoff K, Juul-Larsen HG, Andersen O, Stockmarr A
Co-Occurring Diseases and Mortality in Patients With Chronic Heart Disease, Modeling Their Dynamically Expanding Disease Portfolios: Nationwide Register Study