Table 3.
Multivariable Cox proportional hazards regression models estimating effect of multimorbidity patterns on overall mortality, hospitalizations, and ED visitsa
| Multimorbidity pattern | Mortality HR (95% CI) | ED visit HR (95% CI) | Hospitalization HR (95% CI) |
|---|---|---|---|
| Primary analysis | |||
| Minimal comorbidity | Reference | Reference | Reference |
| Cardiovascular and metabolic | 1.16 (1.06 to 1.26) | 1.22 (1.11 to 1.34) | 1.17 (1.07 to 1.29) |
| Psychiatric and substance use disorders | 1.62 (1.42 to 1.84) | 1.67 (1.47 to 1.90) | 1.52 (1.34 to 1.73) |
| Chronic lung disease | 1.52 (1.37 to 1.68) | 1.28 (1.15 to 1.44) | 1.44 (1.29 to 1.61) |
| Multisystem impairment | 1.89 (1.70 to 2.11) | 1.62 (1.44 to 1.82) | 1.55 (1.38 to 1.74) |
| Secondary analysis, further adjusting for Charlson Index | |||
| Minimal comorbidity | Reference | Reference | Reference |
| Cardiovascular and metabolic | 1.02 (0.93 to 1.13) | 0.94 (0.85 to 1.04) | 0.92 (0.84 to 1.02) |
| Psychiatric and substance use disorders | 1.42 (1.24 to 1.63) | 1.26 (1.10 to 1.45) | 1.17 (1.03 to 1.34) |
| Chronic lung disease | 1.32 (1.18 to 1.47) | 0.95 (0.84 to 1.08) | 1.11 (0.99 to 1.25) |
| Multisystem impairment | 1.39 (1.21 to 1.59) | 0.87 (0.76 to 1.02) | 0.88 (0.76 to 1.01) |
a
All analyses were on imputed data. For our primary analysis, models were adjusted for all covariates, including age at MM diagnosis, sex, race, income, ISS stage, calcium greater than or equal to 11 mg/dL, creatinine greater than 2 mg/dL, hemoglobin less than 10 g/dL, and platelet less than 150 000/microL. For our secondary analysis, models were further adjusted for the Charlson Index. CI = confidence interval; ED = emergency department; HR = hazard ratio; International Staging System; MM = multiple myeloma.