Multimorbidity and Disease Severity Measured by the Charlson Index in Portuguese Hospitalised Patients During the Year 2015: A Cross-Sectional Study

Paula Broeiro-Gonçalves, Paulo Nogueira, Pedro Aguiar


Introduction: The association between multimorbidity and disease severity is not well established. The objectives were to characterise multimorbidity and determine disease severity (trough Charlson), as well as to verify if there is an association between the number and type of disease and the Charlson index.

Material and Methods: A cross-sectional study based on exported data from the Portuguese National Health Service hospitalisations database, during the year 2015. The study included 22 chronic health conditions: 15 predicted in the Charlson index and seven frequent conditions (hypertension, obesity, dyslipidaemia, osteoarthritis, osteoporosis, anxiety and depression). The analysis was performed through the generalised linear model, considering binary logistic regression. In the analysis, the IBM SPSS version 24.0 tool was used.

Results: The study analysed 800 376 hospitalisations, from which 42% correspond to males. The average age of the sample was 59.8 years, being higher in men (62.3 years). The mean number of problems per person was 1.6, greater in men (1.8). Disease severity was also higher in males. The worst prognosis was associated with six or more conditions per person. The largest predictor of disease severity was the number of problems, followed by dementia and diabetes.

Discussion: The results seem to confirm the gender difference regarding morbidity pattern. The number of conditions per person was the greatest predictor of disease severity, particularly the presence of six or more conditions per person.

Conclusion: The major limitation was the use of the same medical conditions to measure multimorbidity and disease severity. Other studies and analysis models should explore the complexity of the multimorbidity phenomenon.


Comorbidity; Multimorbidity; Portugal; Severity of Illness Index

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