Polypathology as a Marker of Care Complexity in Hospitalized Adults with Multimorbidity in México
4 affiliations
- 1Departamento de Clínicas Médicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
- 2Departamento de Medicina Interna, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara 44340, Jalisco, Mexico
- 3Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
- 4Departamento de Medicina Interna, Hospital General de Mazatlán, Mazatlán 82267, Sinaloa, Mexico
Abstract
Background/Objectives: The concept of the polypathological patient was developed in Spain, in older populations, and has not been described in México. We analyzed its frequency, profile, relationship with care burden, and phenotypes in hospitalized adults with multimorbidity and without social security coverage. Methods: This was a retrospective single-center cohort of patients with multimorbidity admitted to the Internal Medicine department of a public university hospital in Guadalajara, Jalisco, Mexico (2023–2024). Polypathology was defined using the 2018 Andalusian criteria. Logistic regression adjusted for age, sex, and the Charlson index, and latent class analysis were used. Results: Of 1108 patients with multimorbidity, 702 (63.4%) were polypathological; their mean age was 61.5 years, 43.6% were younger than 60, and 51.7% were men. Each additional category was associated with polypharmacy (OR 1.58; 95% CI 1.35–1.85) and prior hospitalizations (1.63; 1.36–1.95) at admission and with discharge at maximum therapeutic benefit (1.63; 1.23–2.18), also after adjustment for the Charlson index, but not with death during the index admission (0.94; 0.77–1.16). Seven phenotypes were identified, which differed in polypharmacy and prior hospitalizations but not in mortality. Conclusions: In this cohort, polypathology was frequent, affected patients about 15 years younger than in Spanish cohorts, although the cohorts differ in population and setting, and was associated with markers of care burden, with no clear association with in-hospital mortality. Prospective multicenter studies are needed to confirm these findings.
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BibTeX
@article{arellanoarteaga2026polypathology,
title = {{Polypathology as a Marker of Care Complexity in Hospitalized Adults with Multimorbidity in México}},
author = {Kevin Javier Arellano-Arteaga and Javier Israel Campechano-Aguirre and Elvira Miramontes-Luna and Martin Bedolla-Barajas and Jorge Andrade-Sierra and Francisco Gerardo Yanowsky-Escatell and Pablo Maggiani-Aguilera},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218722},
url = {https://www.mdpi.com/2077-0383/15/21/8722},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Polypathology as a Marker of Care Complexity in Hospitalized Adults with Multimorbidity in México
AU - Kevin Javier Arellano-Arteaga
AU - Javier Israel Campechano-Aguirre
AU - Elvira Miramontes-Luna
AU - Martin Bedolla-Barajas
AU - Jorge Andrade-Sierra
AU - Francisco Gerardo Yanowsky-Escatell
AU - Pablo Maggiani-Aguilera
PY - 2026
DA - 2026/11/08
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218722
UR - https://www.mdpi.com/2077-0383/15/21/8722
AB - Background/Objectives: The concept of the polypathological patient was developed in Spain, in older populations, and has not been described in México. We analyzed its frequency, profile, relationship with care burden, and phenotypes in hospitalized adults with multimorbidity and without social security coverage. Methods: This was a retrospective single-center cohort of patients with multimorbidity admitted to the Internal Medicine department of a public university hospital in Guadalajara, Jalisco, Mexico (2023–2024). Polypathology was defined using the 2018 Andalusian criteria. Logistic regression adjusted for age, sex, and the Charlson index, and latent class analysis were used. Results: Of 1108 patients with multimorbidity, 702 (63.4%) were polypathological; their mean age was 61.5 years, 43.6% were younger than 60, and 51.7% were men. Each additional category was associated with polypharmacy (OR 1.58; 95% CI 1.35–1.85) and prior hospitalizations (1.63; 1.36–1.95) at admission and with discharge at maximum therapeutic benefit (1.63; 1.23–2.18), also after adjustment for the Charlson index, but not with death during the index admission (0.94; 0.77–1.16). Seven phenotypes were identified, which differed in polypharmacy and prior hospitalizations but not in mortality. Conclusions: In this cohort, polypathology was frequent, affected patients about 15 years younger than in Spanish cohorts, although the cohorts differ in population and setting, and was associated with markers of care burden, with no clear association with in-hospital mortality. Prospective multicenter studies are needed to confirm these findings.
SN - 2077-0383
ER -