Risk factors and mortality associated with multimorbidity in people with stroke or transient ischaemic attack: a study of 8,751 UK Biobank participants

Gallacher, K. I. , McQueenie, R., Nicholl, B. , Jani, B. D. , Lee, D. and Mair, F. S. (2018) Risk factors and mortality associated with multimorbidity in people with stroke or transient ischaemic attack: a study of 8,751 UK Biobank participants. Journal of Comorbidity, 8(1), pp. 1-8. (doi:10.15256/joc.2018.8.129)

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Abstract

Background: Multimorbidity is common in stroke, but the risk factors and effects on mortality remain poorly understood. Objective: To examine multimorbidity and its associations with sociodemographic/lifestyle risk factors and all-cause mortality in UK Biobank participants with stroke or transient ischaemic attack (TIA). Design: Data were obtained from an anonymized community cohort aged 40–72 years. Overall, 42 comorbidities were self-reported by those with stroke or TIA. Relative risk ratios demonstrated associations between participant characteristics and number of comorbidities. Hazard ratios demonstrated associations between the number and type of comorbidities and all-cause mortality. Results were adjusted for age, sex, socioeconomic status, smoking, and alcohol intake. Data were linked to national mortality data. Median follow-up was 7 years. Results: Of 8,751 participants (mean age 60.9±6.7 years) with stroke or TIA, the all-cause mortality rate over 7 years was 8.4%. Over 85% reported ≥1 comorbidities. Age, socioeconomic deprivation, smoking and less frequent alcohol intake were associated with higher levels of multimorbidity. Increasing multimorbidity was associated with higher all-cause mortality. Mortality risk was double for those with ≥5 comorbidities compared to those with none. Having cancer, coronary heart disease, diabetes, or chronic obstructive pulmonary disease significantly increased mortality risk. Presence of any cardiometabolic comorbidity significantly increased mortality risk, as did any non-cardiometabolic comorbidity. Conclusions: In stroke survivors, the number of comorbidities may be a more helpful predictor of mortality than type of condition. Stroke guidelines should take greater account of comorbidities, and interventions are needed that improve outcomes for people with multimorbidity and stroke.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Jani, Dr Bhautesh and Lee, Professor Duncan and Gallacher, Dr Katie and Mair, Professor Frances and Nicholl, Dr Barbara and McQueenie, Dr Ross
Authors: Gallacher, K. I., McQueenie, R., Nicholl, B., Jani, B. D., Lee, D., and Mair, F. S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Science and Engineering > School of Mathematics and Statistics > Statistics
Journal Name:Journal of Comorbidity
Publisher:Swiss Medical Press GmbH
ISSN:2235-042X
ISSN (Online):2235-042X
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Journal of Comorbidity 8(1):1-8
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
756021Multimorbidity in UK BiobankBarbara NichollChief Scientist office (CSO)CGA/16/39IHW - GENERAL PRACTICE & PRIMARY CARE
716251Patterns of co-morbidity in stroke and associations with hospital admission and mortality - an observational studyKatie GallacherThe Carnegie Trust for the Universities of Scotland (CARNEGTR)70363IHW - GENERAL PRACTICE & PRIMARY CARE