Los pacientes pluripatológicos (PP) representan un reto para los sistemas sanitarios por su elevada frecuencia, consumo de recursos y peor pronóstico. En el ámbito hospitalario suponen aproximadamente uno de cada 4 ingresos. Aunque presentan con frecuencia complicaciones, existe escasa información sobre su tipo, frecuencia, impacto y factores asociados. El objetivo es analizar las complicaciones intrahospitalarias en los PP y su impacto en los resultados en salud.

Estudio observacional prospectivo (febrero 2022-junio 2023). Se incluyeron PP mayores de 18 años ingresados por cualquier motivo, con consentimiento informado, excluyendo los fallecidos durante el ingreso. Se recogieron variables sociodemográficas, comorbilidad, motivo de ingreso, criterios de pluripatología, tipo y frecuencia de complicaciones, fragilidad, estancia media, reingresos y mortalidad a 30 días.

Se incluyeron 535 pacientes (edad media: 82,2 años); 334 (62,4%) desarrollaron al menos una complicación (682 eventos). Las más frecuentes fueron neurológicas (25,4%), digestivas (19%), hematológicas (16%) y cardiovasculares (15,7%). Los pacientes con complicaciones presentaron mayor estancia media (11,6 vs. 7,3 días; p<0,001) y mayor mortalidad a 30 días (10,5 vs. 4,5%; p<0,05). En el análisis multivariante, deterioro cognitivo, enfermedad prostática, índice VIG-Frail >0,4, anemia al ingreso y estancia >6 días se asociaron a mayor riesgo (AUC: 0,713; IC 95%: 0,669-0,756).

Las complicaciones intrahospitalarias son frecuentes en los PP, y se asocian a peor evolución. Su identificación precoz podría facilitar estrategias preventivas y mejorar los resultados en esta población vulnerable.

Multimorbid patients (MP) represent a major challenge for healthcare systems due to their high prevalence, resource utilization, and poorer prognosis. In the hospital setting, they account for approximately one in four admissions. Although complications are common in this population, there is limited information regarding their type, frequency, impact, and associated factors. The aim of this study was to analyze in-hospital complications in multimorbid patients and their impact on health outcomes.

Prospective observational study conducted between February 2022 and June 2023. Multimorbid patients aged ≥18 years admitted for any reason were included after providing informed consent; patients who died during hospitalization were excluded. Variables collected included sociodemographic characteristics, comorbidities, reason for admission, multimorbidity criteria, type and frequency of complications, frailty, length of stay, readmissions, and 30-day mortality.

A total of 535 patients were included (mean age 82.2 years); 334 (62.4%) developed at least one complication, accounting for 682 events. The most frequent were neurological (25.4%), digestive (19%), hematological (16%), and cardiovascular (15.7%). Patients with complications had a longer length of stay (11.6 vs. 7.3 days; P<.001) and higher 30-day mortality (10.5 vs. 4.5%; P<.05). In multivariate analysis, cognitive impairment, prostate disease, VIG-Frail index >0.4, anemia at admission, and hospital stay >6 days were associated with increased risk (AUC: 0.713; 95% CI: 0.669-0.756).

In-hospital complications are common among multimorbid patients and are associated with worse outcomes. Early identification of high-risk patients may enable preventive strategies and improve outcomes in this vulnerable population.