Nursing Research and Practice (Jan 2013)

Measuring Comorbidity in Cardiovascular Research: A Systematic Review

  • Harleah G. Buck,
  • Jabar A. Akbar,
  • Sarah Jingying Zhang,
  • Janet A. Prvu Bettger

DOI
https://doi.org/10.1155/2013/563246
Journal volume & issue
Vol. 2013

Abstract

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Background. Everything known about the roles, relationships, and repercussions of comorbidity in cardiovascular disease is shaped by how comorbidity is currently measured. Objectives. To critically examine how comorbidity is measured in randomized controlled trials or clinical trials and prospective observational studies in acute myocardial infarction (AMI), heart failure (HF), or stroke. Design. Systematic review of studies of hospitalized adults from MEDLINE CINAHL, PsychINFO, and ISI Web of Science Social Science databases. At least two reviewers screened and extracted all data. Results. From 1432 reviewed abstracts, 26 studies were included (AMI , HF , stroke ). Five studies used an instrument to measure comorbidity while the remaining used the presence or absence of an unsubstantiated list of individual diseases. Comorbidity data were obtained from 1–4 different sources with 35% of studies not reporting the source. A year-by-year analysis showed no changes in measurement. Conclusions. The measurement of comorbidity remains limited to a list of conditions without stated rationale or standards increasing the likelihood that the true impact is underestimated.