Polypathology as a Marker of Care Complexity in Hospitalized Adults with Multimorbidity in México

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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Journal
Journal of Clinical Medicine
Published
2026-11-08
DOI
https://doi.org/10.3390/jcm15218722
Primary Topic
Chronic Disease Management Strategies
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article
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article

Polypathology as a Marker of Care Complexity in Hospitalized Adults with Multimorbidity in México

Kevin Javier Arellano-Arteaga, Pablo Maggiani‐Aguilera, Martín Bedolla‐Barajas, Francisco Gerardo Yanowsky-Escatell et al.
Journal of Clinical Medicine
Chronic Disease Management Strategies
article

Polypathology as a Marker of Care Complexity in Hospitalized Adults with Multimorbidity in México

Kevin Javier Arellano-Arteaga, Pablo Maggiani‐Aguilera, Martín Bedolla‐Barajas, Francisco Gerardo Yanowsky-Escatell, Jorge Andrade‐Sierra, Elvira Miramontes Luna, Javier Israel Campechano-Aguirre
article en

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.

Journal of Clinical MedicineVol. 15(21)
Universidad de Guadalajara (MX), Hospital Civil de Guadalajara (MX)
Chronic Disease Management Strategies
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