Natna pakhat aia tam i nei em? Heng comorbidities te hi han sawi ila!

A châng chuan Doctor kan pan hian an thusawi ṭhenkhat chu a hlauhawm deuh thei a ni lawm ni? Chutiang thumal pakhat chu ‘Comorbidities’ tih hi a ni. Mahse hengte hi eng nge an nih leh i hriselna a nghawng dan hriatthiamna chuan i natnate hmachhawn kawngah nasa takin a pui thei che a ni. Chuvangin vawiin hian he thu hi han sawi ila.

Chuti a nih chuan heng comorbidities te hi engte nge ni?

A awlsam zawngin, comorbidities chu i natna ber bakah natna dang pakhat emaw a aia tam emaw awmna a ni. Damdawi lam thumal "morbidity" tih hian natna emaw, dinhmun emaw awmna a kawk a ni. Chuvangin "co" tih hmaa a awm chuan natna pahnih emaw a aia tam emaw a awm dun tihna a ni.

``Comorbidity'' tih thumal hi hriat a hlauhawm deuh thei. Mahse a awmzia leh i hriselna a nghawng dan i hriatthiam hnu chuan i hriselna enkawlna kawngah nasa takin i thawk thei tawh ang. Heng comorbidities te hian an in nghawng thei a, chuvang chuan i health plan pawh chutiang chuan a danglam thei a ni.

Hei hi han mitthla teh. I doctor chuan i thau lutuk control nan nitin kea kal turin a hrilh che a . Mahse ni engemaw zat hnuah chuan osteoarthritis i vei tih i hrechhuak ta a ni . Chuvangin, nitin kea kal ai chuan i ruh natna a zual loh nan water aerobics lam i pan thei ang. Hetiang a nih chuan osteoarthritis hi thau lutuk nen comorbidity a ni. Chuvangin, i thau lutuk i enkawl dan chu a danglam thin.

Entirna dang chu thisen sang (Hypertension) . Thil dang, lung natna emaw, lung natna emaw nei te pawhin thisen sang an nei thei bawk. Thil dang nena thisen sang i neih chuan i doctor pawhin chutiang dinhmun chu a ngaihtuah ang. I damdawi ei tur dang tibuai lo tur thisen sang tihhniamna damdawi a pek a ngai mai thei.

Comorbidities concept hi medical field-ah chuan a pawimawh hle. Chuvângin, a awmzia hriatna chuan i doctor nêna inbiaknaah a ṭanpui thei che a, i enkawlna ruahmanna chu a hrethiam zâwk thei bawk. I hmangaih tak takte damdawi lam dinhmunah pawh a \angkai thei bawk.

Comorbidities sawina atana hman tur thumal dang thenkhat chu hetiang hi a ni:

• Thil awmdan (coexisting conditions) te
• A kaihhnawih dinhmunte
• Chronic condition hrang hrang a awm
• Multimorbidity a awm thei

Primary diagnosis leh comorbidities te hi eng nge an danglamna?

Comorbidity hi i primary diagnosis (a then chuan underlying diagnosis emaw index disease an tih) bakah i neih thin medical condition chiang taka hriat chhuah a ni. Tunah chuan, "He primary diagnosis hi eng nge ni?" Heng thumalte hrilhfiahna hi a takah chuan a buaithlak deuh a ni.

Damdawi khawvelah chuan, .Natna lian tak chu hun bituk emaw, hun bituk chhunga emaw i enkawlna tur damdawi lam dinhmun a ni. I natna khirh ber a ni thei a, a nih loh leh specialist enkawlna mamawh ber pawh a ni thei bawk. Damdawi ina i awm chhan pawh a ni thei.

Natna chu doctor sawi tur chuan natna "main" atan a ruat a ni. I natna ber pawh hi doctor i hmuh leh i hriselna a inthlak dan azirin a danglam thei bawk.

Entirnan, Chronic Kidney Disease, High Blood Pressure, leh Type 2 Diabetes i nei tih han ngaihtuah teh. Nephrologist i hmu a, i kal natna chu enkawl fo i ni. Tichuan, chu doctor chuan i kal natna chu i natna ber atan a ngai ta a ni. A chhan chu chu chu a enkawl dan a ni. Thisen sang leh zunthlum hi kal natna comorbidities angin a ngai a ni. I kal natna a enkawl hian heng comorbidities te hi a enkawl bawk.

He entîrna hi sawi belh ila, i zunthlum enkawl nân endocrinologist i hmu fo ang tih han ngaihtuah teh. Tichuan chu doctor chuan i natna bulpui ber chu zunthlum niin a ngai ta a ni. I kal natna leh thisen sang hi zunthlum comorbidities ah a ngai a ni.

Chuvangin i hmu thei ang, eng nge natna ber leh eng nge comorbidity chu thil awmdan azirin a danglam thei. Specialist doctor-te chuan i hriselna dinhmun hi natna lian ber leh a kaihhnawih comorbidities-ah an ngai fo thin.

Mahse i chhungkaw doctor (Primary Care Provider) ang mite chuan hei hi a danglam deuhin an thlir mai thei. I hriselna thlirna zau zawk neih theih nan ``Multimorbidity'' tih concept pawh an hmang thei bawk.

Multimorbidity hi hetiang hi a ni em?

United States Department of Health and Human Services chuan ``multimorbidity'' tih chu damdawi lam natna emaw, kum khat aia rei awm thei dinhmun pahnih tal awm tihna a ni He hrilhfiahna hian natna bulpui (primary disease) a sawi lo. Hei hi comorbidity tih awmzia nen a danglam hle.

Zirchiangtu tam tak chuan natna hrang hrangte in nghawng dan zir chianna atan ``multimorbidity'' tih concept hi an hmang thin. Mahse, mi tam tak chuan comorbidity leh multimorbidity tih thumal hi an hmang dun a, chu chu damdawi lam dinhmun pahnih emaw a aia tam emaw awm dun sawina a ni.

Engtin nge heng comorbidities te hian i hriselna a nghawng?

Comorbidities emaw multimorbidity emaw neih hian kawng tam takin i hriselna a nghawng thei a ni. Chronic condition pahnih emaw a aia tam emaw i neih chuan:

• Heng dinhmunte hian mimal aiin i rilru leh/ emaw taksa hriselnaah nghawng lian zawk a nei thei a, i ``Hriselna nena inzawm nunphung``-ah pawh nghawng nasa zawk a nei thei bawk.
• Comorbidity avang hian i natna bulpui ber tur hun rei tak chhunga i thlir dan chu a danglam thei a ni.
• Enkawlna hi a buaithlak thei hle. Entîr nân, natna pakhat enkawlna chuan natna dang a tichhe thei a ni. A nih loh leh, dinhmun hrang hrang damdawi ei dun hi a hlauhawm thei hle.
• Specialist hrang hrang engemawzat i hmuh a ngai mai thei . Team angin an thawk ho ang a, an hriatna an insem ang a, i tana enkawlna tur ruahmanna tha ber an siam ang.

Comorbidities awm tam ber chu engte nge ni tih i lo en ang u.

Damdawi ina inpatient treatment dawngtu damlo leh damdawi lam harsatna hrang hrang tuar zingah comorbidities hrang hrang hmuh tur a awm.

Damdawi ina awm zingah

Zirchianna pakhatah chuan kum 2019 khan United States-a damdawi ina enkawl puitling 84% aia tam chuan comorbidities pakhat emaw a aia tam emaw an nei tih hmuhchhuah a ni a, hei bakah hian damdawi ina an awm chhan underlying condition pawh a awm bawk. He group zinga 50% vel hian comorbidities pathum tal an nei a ni.

Chu zirchiannaa comorbidities hmuhchhuah tam ber chu:

• Thisen sang (inpatient zinga 53.2%) 1.1.
• Zunthlum (inpatient zinga 26.4%) 1.1.
• Lung natna rei tak (inpatient zinga 20.5%) .
• Deficiency thisen tlakchhamna (inpatient zinga 18.0%) 1.1.
• Thau lutuk (inpatient zinga 17.0%) 1.1.
• Kidney natna leh failure (inpatient zinga 16.3%) .

He zirchianna hian thil dang engemaw zat a hmuchhuak bawk:

• Kum upat deuh deuh hian comorbidities a pung zel. Kum 18-24 inkar puitling zinga 8% chauhvin comorbidities pathum tal an nei a ni. Mahse, kum 85 aia upa zinga 73% vel chuan comorbidities pathum tal an nei a ni.
• Comorbidities hian outcome a nghawng a ni. Comorbidities pathum emaw a aia tam emaw nei te hian damdawi inah an awm rei zawk a, comorbidities tlem emaw nei lo emaw te aiin damdawi inah an thih tam zawk. Comorbidities hian surgery chungchangah hian nghawng a nei nasa hle. Comorbidities pathum emaw a aia tam emaw nei te chu comorbidities nei lo te aiin operation hnua damdawi inah an thihna a let riat zetin an tam zawk.

Natna lian thenkhat nena hmuh tur comorbidities

Researcher-te chuan natna bik – entirnan, arthritis emaw heart failure emaw nei te chu an zirchiang fo thin a, eng condition dang (comorbidities) nge an neih tih an zirchiang fo thin. Dik tak chuan mi zawng zawng hi kan danglam vek a, heng zirchiannate hian natna bik nei zawng zawng hian comorbidities engemaw zat an nei vek dawn tihna a ni hauh lo. Mahse, common pattern chungchang ngaihtuahna min pe a ni.

Entirna thenkhat han en ila:

• Attention-Deficit/Hyperactivity Disorder (ADHD) a ni a, a rilru a hah lutuk a, a rilru a buai em em bawk a.
• Comorbidities tlangpui: Depression, lungkhamna, bipolar disorder.

• Type 2 Diabetes a ni
• Comorbidities tlangpui: Thisen sang, thisen thau sang (e.g. cholesterol sang leh/ emaw triglycerides sang - Dyslipidemia), Metabolic dysfunction-associated steatotic liver disease - MASLD, Polycystic Ovary Syndrome - PCOS, Obesity, Obstructive Sleep Apnea.

• Lung lam chak lohna
• Comorbidities tlangpui: Type 2 Diabetes, Sleep Apnea, Thau lutuk, Thisen sang.

A châng chuan, natna hi a chhan inang emaw, a hlauhawmna emaw a neih vang a ni. Entirnan, thisen sang leh zunthlum hian thinlung natna leh kal natna vei theihna a tipung thei vek a ni. Mahse a chang chuan comorbidities hian common underlying cause a nei lo. I doctor chuan i dinhmun chhan leh enkawlnain a puih theih dan tur a hrilh belh thei che a ni.

Chuti a nih chuan he thil hi i hriat chian a pawimawhzia chu eng nge ni?

Comorbidities leh multimorbidities tih thumal awmzia hriat hian i hriselna chungchang doctor nen inbiakna neihpui turin a pui thei che a ni. Mahse heng thumalte hian a tihbuai che nia i hriat chuan chawlhsan la, rei lo te chhung ngaihtuah rawh.

A pawimawh ber chu damdawi lam thumal zawng zawng hi zir vek loh hi a ni. A pawimawh ber chu i damdawi lam dinhmun leh chu chuan i hriselna a nghawng dan zir turin hun i hmang a ni. Eng enkawlna nge i mamawh theih ang tih te, i mamawh chhan te, leh in lama i damdawi hman dan tur te hrethiam rawh. Tin, mi pahnih hian dinhmun inang emaw, dinhmun inzawmkhawm emaw chu a danglam bik lo tih hriat a pawimawh bawk.

I doctor hnenah i zawhna leh ngaihtuahna zawng zawng hrilh la, chutiang chuan i dinhmun bik ang zela kaihhruaina a pe thei ang che.

He thuziak atanga take-home message chu hetiang hi a ni:

Okay, chuvangin, vawiin a kan sawi tawh atang hian i hriat reng tur pawimawh ber berte chu hetiang hi a ni:

• Comorbidities hi a awm fo thin: primary illness bakah natna dang pakhat emaw a aia tam emaw awmna, mi tam takin an tawn thin thil a ni.
• Hriatthiam a pawimawh: Heng comorbidities te hi hriat chian a, i hriselna a nghawng dan hriatthiam hi i hriselna zawng zawng enkawlna kawngah a pui hle.
• Enkawlna chu a buaithlak thei hle:Natna pakhat aia tam i neih chuan enkawl dan tur ruahmanna siam hi a buaithlak deuh thei a, chuvangin i doctor thupek dik taka zawm a pawimawh hle.
• I doctor nen inbiakna nei rawh: Damdawi lam harsatna i neih leh damdawi i ei zawng zawng chu i doctor hnenah hrilh rawh. Zawhna leh ngaihtuahna i neih chuan zawt hreh suh. I healthcare team te chu i tanpui turin an awm reng a ni.

Nangmah chauh i ni lo tih hre reng ang che. Hetiang dinhmun neia khawsa mi tam tak an awm. Hriatna dik tak, ṭanpuina dik tak, leh damdawi lam thurâwn i neih chuan nang pawhin heng dinhmunte hi hlawhtling takin i hmachhawn thei a ni!

` Comorbidities, Multiple Conditions, Primary Diagnosis, Multimorbidity, Natna rei tak, Hriselna enkawl dan, Damdawi lam thurawn