Bernabeu-Wittel et al listed conditions used to define polypathology in a patient. The authors are from multiple hospitals in Spain.
A patient was defined as being a polypathology patients if s/he had 2 or more chronic disorders in the listed clinical categories.
chronic heart failure >= Stage II NYHA AND/OR
coronary artery disease
vasculitis or systemic autoimmune disorder AND/OR
chronic renal disease (elevated creatinine and/or proteinuria)
chronic lung disease with any of the following: dyspnea >= Stage 2 MRC, FEV1 < 65% of predicted, basal oxygen saturation <= 90%
chronic inflammatory bowel disease AND/OR
chronic liver disease with portal hypertension
stroke (cerebrovascular disease) AND/OR
a neurological disorder with permanent motor deficit causing severe deficit in activities of daily living AND/OR
a neurological disease with permanent moderate to severe cognitive impairment
symptomatic peripheral artery disease AND/OR
diabetes mellitus with neuropathy or proliferative retinopathy
chronic anemia AND/OR
solid organ active neoplasia AND/OR
hematologic active neoplasia
chronic osteoarticular disease with severe impairment in activities of daily living (ADL)
• Chronic renal failure: creatinine > 1.4 mg/dL in male, creatinine > 1.3 mg/dL in female for >= 3 months.
• Proteinuria >= 3 months: albumin to creatinine ratio > 300 mg/g, microalbuminuria > 3 mg/dL, albumin > 300 mg/day, or albuminuria > 200 micrograms per minute.
• Chronic anemia: hemoglobin < 10 g/dL for >= 3 months
• Most of the conditions were associated with significant impairment in activities of daily living (ADL).
Patients with polypathology tend:
(1) to be highly complex
(2) to have a high symptom load
(3) to be clinically vulnerable
(4) to be functionally impaired
(5) to be dependent on their caregivers
(6) to have limited social resources
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Purpose: To determine if a patient has polypathology based on the criteria of Bernabeu-Wittel et al.
Objective: criteria for diagnosis, complications