• Semergen · Mar 2020

    Multicenter Study Observational Study

    [Mortality and associated factors of patients with complex chronic diseases in rural and social transformation areas in Andalusia].

    • B Pascual-de la Pisa, C Cuberos-Sánchez, C Marquez-Calzada, M J Garcia-Lozano, J Pardo-Alvarez, and M Ollero-Baturone.
    • Unidad de Gestión Clínica de Camas, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud; Calle Santa María de Gracia s/n, 41900, Camas, Sevilla, España; Departamento de Medicina Facultad de Medicina de Sevilla; Avenida Sánchez Pizjuán s/n, 41009, Sevilla, España. Electronic address: beatriz.pascual.pisa@gmail.com.
    • Semergen. 2020 Mar 1; 46 (2): 115-124.

    ObjectiveTo determine one-year mortality and associated factors in patients with complex chronic diseases (CCP) in rural health centres and social transformation needs areas (STNA) in Primary Health Care (PHC) in Andalusia.Material And MethodsDesign: 1-Year longitudinal observational prospective open study.Setting40 health centre.Subjectsconsenting subjects over 18yr according multiple health condition criteria.Sample Size814 subjects (confidence interval 95%, alpha risk 0.03%, p=.2; 20% of sample increase due to possible losses). End-point: 1-year Mortality.Independent Variablessocio-demographic, socio-familial, clinical, functional (Barthel Index -BI-, Lawton-Brody Index), cognitive (Pfeiffer Test), prescribed drugs, social healthcare resources consumption, and quality of life (EQ-5D).Data SourceInterview and computerised clinical history Results: A total of 832 CCP were included (48.8% women). One-year mortality was 17.8% (n=148). Logistic regression model for mortality included: aged 85 and over, having a caregiver, haemoglobin level less 10g/L, hospital admission in last year, BI under 60 points, and active neoplasia. The calibration obtained from model was good (p=.85 in the Hosmer-Lemeshow goodness-of-fit test), and the discrimination power also good (AUC=0.772 [0.68-0.77] in ROC curve).Conclusions1-year mortality of CCP in rural centres and STNA in PHC was 17.8%. Knowledge of the factors related to the mortality of CCP helps to approach the needs and social-health resources management.Copyright © 2019 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

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