Background: The associated comorbidities in atherothrombotic disease (ATD) patients impose significant challenges in the disease management. We investigated the prevalence and pattern of multimorbidity (presence of two or more chronic conditions) in Aboriginal and non-Aboriginal Western Australian (WA) residents with ATDs.
Methods: We identified a cohort of patients aged 25-59 years admitted to WA hospitals with a discharge diagnosis of ATD (from 1 January 2000 to 30 June 2014) using a population-based linked administrative health data. Multimorbidity patterns were empirically explored through latent class analysis.
Results: Half of the cohort had multimorbidity, although this was much higher in Aboriginal people (Aboriginal: 79.2% vs. non-Aboriginal: 39.3%). Only a quarter were without any documented comorbidities. Hypertension, diabetes, alcohol abuse disorders and acid peptic diseases were the leading comorbidities in the major comorbid combinations across both Aboriginal and non-Aboriginal cohorts. We identified four and six distinct clinically meaningful classes of multimorbidity for Aboriginal and non-Aboriginal patients, respectively. Out of the six groups in non-Aboriginal patients, four were similar to that identified in Aboriginal patients. The largest proportion of patients (33% in Aboriginal and 66% in non-Aboriginal) was assigned to the relatively healthy group, with most patients having less than two conditions. Other groups showed variability in degree and pattern of multimorbidity.
Conclusion: Multimorbidity is common in ATD patients and the comorbidities tend to interact and cluster together. Physicians need to consider these in their clinical practice. Different treatment and secondary prevention strategies are likely to be useful for management in these cluster groups.