Comorbilidad y hábito tabáquico en pacientes atendidos en Servicios de Medicina Interna. Estudio COTAMIR

Abstract

Comorbidity means that one or more diseases could be associated to another disorder under study in a given patient. It is important in terms of prognosis and thus measure of comorbidity is necessary to assess the results of medical trials or in clinical practice. Besides, smoking can modify comorbidity increasing it. This study has been performed in hospitals of Galicia (North West of Spain) to evaluate comorbidity and smoking impact in patients attended in Internal Medicine Departments. A total of 2659 patients were included. Variables like hypertension, anemia, depression, thromboembolic disease, atrial fibrillation, alcohol intake as well as the items included in the Charlson comorbidity index (CCI) were reported. CCI score and correction by age were included. Patients were mainly of old age (mean age 71 years-old) and the most frequently detected comorbidities were hypertension, anemia, depression, atrial fibrillation, heart failure, myocardial infarction, diabetes mellitus, cerebrovascular disease, dementia and COPD. Mean CCI was 3,91, being 6,74 after correction by age. Only 13% patients were active smokers while 64% patients had never smoked. Smoking was mainly associated to vascular and oncological diseases. Men smoke more, and have predominantly atherosclerosis while women have more cerebrovascular disease, atrial fibrillation or dementia. This study describes internal medicine patients as a mainly elderly population, with a high level of comorbidities, especially vascular in a wide sense, and without being heavy smokers.