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

Gallacher, Katie I. ORCID: https://orcid.org/0000-0001-8620-8758, McQueenie, Ross, Nicholl, Barbara ORCID: https://orcid.org/0000-0001-5639-0130, Jani, Bhautesh D. ORCID: https://orcid.org/0000-0001-7348-514X, Lee, Duncan ORCID: https://orcid.org/0000-0002-6175-6800 and Mair, Frances S. ORCID: https://orcid.org/0000-0001-9780-1135(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)

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.

University Staff: Request a correction | Enlighten Editors: Update this record

Funder and Project Information

1

Multimorbidity in UK Biobank

Barbara Nicholl

CGA/16/39

IHW - GENERAL PRACTICE & PRIMARY CARE

1

Patterns of co-morbidity in stroke and associations with hospital admission and mortality - an observational study

Katie Gallacher

70363

IHW - GENERAL PRACTICE & PRIMARY CARE

Deposit and Record Details