title: Multimorbidity in adult asylum seekers: a first overview.
abstract: BACKGROUND
  Over the last two decades, the total annual number of applications for asylum in the countries of the European Union has increased from 15,000 to more than 300,000 people. The aim of this study was to give a first overview on multimorbidity of adult asylum seekers.
  
  
  METHODS
  Our retrospective Swiss single center data analysis examined multimorbidity of adult asylums seekers admitted to our ED between 1 January 2000 and 31 December 2012.
  
  
  RESULTS
  A total of 3170 patients were eligible for the study; they were predominantly male (2392 male, 75.5% versus 778 female, 24.5). The median age of the patients was 28 years (range 28-82). The most common region of origin was Africa (1544, 48.7%), followed by the Middle East (736, 23.6%). 2144 (67.6%) of all patients were not multimorbid. A total of 1183 (37.7%) of our patients were multimorbid. The mean Charlson comorbidity index was 0.25 (SD 1.1, range 0-12). 634 (20%) of all patients sufferem from psychiatric diseases, followed by chronic medical conditions (12.6%, 399) and infectious diseases (4.7%, 150). Overall, 11% (349) of our patients presented as a direct consequence of prior violence. Patients from Sri Lanka/India most often suffered from addictions problems (50/240, 20.8%, p<0.0001). Infectious diseases were most frequent in patients from Africa (6.6%), followed by the Balkans and Eastern Europe/Russia (each 3.8%).
  
  
  CONCLUSIONS
  The health care problems of asylum seekers are manifold. More than 60% of the study population assessed in our study did not suffer from more than one disease. Nevertheless a significant percentage of asylum seekers is multimorbid and exhibits underlying psychiatric, infectious or chronic medical conditions despite their young age.
authors.affiliation: University Department of General Internal Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Pfortmueller
authors.affiliation: Division of General Internal Medicine, Baden Cantonal Hospital, Baden, Switzerland.
authors.forename: Manuela
authors.initials: M
authors.lastname: Stotz
authors.affiliation: University Department of General Internal Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Gregor
authors.initials: G
authors.lastname: Lindner
authors.affiliation: University Hospital of Psychiatry and University of Bern, Bern, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller
authors.affiliation: University Department of General Internal Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.affiliation: University Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Aristomenis K
authors.initials: AK
authors.lastname: Exadaktylos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005843:Geography; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012036:Refugees / Q000706:statistics & numerical data*; D013557:Switzerland / Q000453:epidemiology