Search for decompensation risk factors within the EGPRN multimorbidity’s definition themes. Cohort pilot study, follow up at 21 months in nursing home

Abstract : Due to an ageing population chronic diseases are in full swing. Multimorbidity concerns a large part of the population both in outpatients and in Nursing Homes. The objective of this study was to identify, at 21 months of follow up, risk factors for decompensation patients with multimorbidity in nursing homes. Méthod : from July 2014 to December 2015, a prospective observational cohort study was conducted at the Lanmeur nursing home in Finistère. Patients meeting the definition of multimorbidity of the European General Practitioners Research Network (EGPRN) were included by their general practitioners. Decompensation was defined as the occurrence of death or hospitalization for at least 7 consecutive days. Twenty-one months after inclusion, patients were divided according to their status into two groups, "Decompensated" ("D") or "Nothing to Report" ("NTR"). A multivariate analysis following the Cox model was performed to identify risk factors for decompensation. Résults : 64 patients were included. 35 belonged to group "D" and 29 to group "RAS". Multivariate analysis using a Cox model found two statistically significant variables: pain (HR = 2.20, 95% CI [1.10-4.40]) which emerged as a decompensation factor, while correct hygiene (HR = 0.44, 95% CI [0.20-0.94]) emerged as a protective factor. Conclusion : pain seems correlated to the risk of death or hospitalization in elderly multi-morbid residents residing in nursing homes while correct hygiene seemed to be correlated with its reduction. The encountered difficulties will be used to improve the methodology which would be usefull as the results needs to be confirmed in a more powerful study at a European level.
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Master Thesis
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Quentin Guillou. Search for decompensation risk factors within the EGPRN multimorbidity’s definition themes. Cohort pilot study, follow up at 21 months in nursing home. Life Sciences [q-bio]. 2018. ⟨dumas-02017507⟩

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