Comorbidity and Dependence on Nursing Care in Patients Admitted to the MedicineService of a Highland Hospital, 2023

Abstract

Background. The care of hospitalized patients, in the context of aging and multiple comorbidities, results in greater clinical complexity and increased nursing care demands. Objective.
To evaluate the association between the comorbidity index and the level of nursing care dependency among patients hospitalized in the Internal Medicine Department of a high-altitude
hospital in Puno, Peru, in 2023. Methods. A cross-sectional analytical study was conducted including 148 patients hospitalized between March and June 2023. Nursing care dependency was assessed using the Perroca Classification, and comorbidities were identified using the Charlson Comorbidity Index. Associations were evaluated using Cramer’s V, Mantel–Haenszel, and Pearson’s chi-square tests, followed by simple correspondence analysis. Results. The mean age was 63.80 ± 16.63 years; 58.78% were older than 60 years and 55.41% were women.
Overall, 76.35% had comorbidities, with a mean of 1.05 ± 0.75 conditions. The age-adjusted Charlson Comorbidity Index averaged 3.05 ± 1.72 points, and 68.24% were classified as having
high comorbidity. According to nursing care dependency, 47.30% required minimal care, 40.54% intermediate care, and 12.16% semi-intensive care. These variables showed a positive
linear association (Mantel–Haenszel, p < 0.001), weak to moderate strength (Cramer’s V = 0.256), statistically significant (p < 0.001), with significant correspondence among categories
(p < 0.001). Conclusion. Higher comorbidity was associated with greater nursing care dependency among patients hospitalized in the Internal Medicine Department of a hospital in the
Puno highlands, 2023.