Navigating Complexities: Clinical Decision-Making in Patients With Multiple Comorbidities

应对复杂局面:多重合并症患者的临床决策

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Abstract

This study aimed to explore the clinical characteristics, comorbidities, and health outcomes of patients with multiple chronic conditions, focusing on gender-based differences and key clinical predictors such as age, BMI, blood pressure, HbA1c, and comorbidities such as diabetes and hypertension. The sample consisted of 450 patients, with nearly equal gender distribution (50.9% females and 49.1% males). Results showed that the most common comorbidities were hypertension (81%), diabetes (72%), and cardiovascular diseases (48%). Exploratory data analysis indicated that the distribution of most clinical variables approximated normality, and significant correlations were observed between BMI and systolic blood pressure (r = 0.65, p < 0.01). Logistic regression revealed that age (OR = 1.05, p = 0.021) and BMI (OR = 1.08, p = 0.045) were significant predictors of atrial fibrillation. The model's Cox & Snell R(2) value was 0.014, indicating that while these variables account for a small portion of the risk for developing atrial fibrillation, additional unmeasured factors likely contribute to the condition. Principal component analysis explained 37.2% of the variance, identifying key components linked to cardiovascular and metabolic health. The study highlights the importance of integrated care strategies that address both metabolic health and cardiovascular health in patients with multimorbidity.

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