Changing Trends in, and Characteristics Associated with, Not Undergoing Cardiac Catheterization in Elderly Adults Hospitalized with ST-Segment Elevation Acute Myocardial Infarction
dc.contributor.author | Tisminetzky, Mayra | |
dc.contributor.author | Erskine, Nathaniel A. | |
dc.contributor.author | Chen, Han-Yang | |
dc.contributor.author | Gore, Joel M. | |
dc.contributor.author | Gurwitz, Jerry H. | |
dc.contributor.author | Yarzebski, Jorge L. | |
dc.contributor.author | Joffe, Samuel W. | |
dc.contributor.author | Shaw, Peter | |
dc.contributor.author | Goldberg, Robert J. | |
dc.date | 2022-08-11T08:08:34.000 | |
dc.date.accessioned | 2022-08-23T15:59:39Z | |
dc.date.available | 2022-08-23T15:59:39Z | |
dc.date.issued | 2015-05-01 | |
dc.date.submitted | 2016-06-15 | |
dc.identifier.citation | J Am Geriatr Soc. 2015 May;63(5):925-31. doi: 10.1111/jgs.13399. Epub 2015 May 4. <a href="http://dx.doi.org/10.1111/jgs.13399">Link to article on publisher's site</a> | |
dc.identifier.issn | 0002-8614 (Linking) | |
dc.identifier.doi | 10.1111/jgs.13399 | |
dc.identifier.pmid | 25940950 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/30718 | |
dc.description.abstract | OBJECTIVES: To describe decade- long trends (1999-2009) in the rates of not undergoing cardiac catheterization and percutaneous coronary intervention (PCI) in individuals aged 65 and older presenting with an ST-segment elevation acute myocardial infarction (STEMI) and factors associated with not undergoing these procedures. DESIGN: Observational population-based study. SETTING: Worcester, Massachusetts, metropolitan area. PARTICIPANTS: Individuals aged 65 and older hospitalized for an STEMI in six biennial periods between 1999 and 2009 at 11 central Massachusetts medical centers (N=960). MEASUREMENTS: Analyses were conducted to examine the characteristics of people who did not undergo cardiac catheterization overall and stratified into two age strata (65-74, > /=75). RESULTS: Between 1999 and 2009, dramatic declines (from 59.4% to 7.5%) were observed in the proportion of older adults who did not undergo cardiac catheterization at all greater Worcester hospitals. These declines were observed in individuals aged 65 to 74 (58.4-6.7%) and in those aged 75 and older (69.4-13.5%). The proportion of individuals not undergoing PCI after undergoing cardiac catheterization decreased from 36.6% in 1999 to 6.5% in 2009. Women, individuals with a prior MI, those with do-not-resuscitate orders, and those with various comorbidities were less likely to have undergone these procedures than comparison groups. CONCLUSION: Older adults who develop an STEMI are increasingly likely to undergo cardiac catheterization and PCI, but several high-risk groups remain less likely to undergo these procedures. | |
dc.language.iso | en_US | |
dc.relation | <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=25940950&dopt=Abstract">Link to Article in PubMed</a> | |
dc.relation.url | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439287/ | |
dc.subject | ST-segment elevation acute myocardial infarction | |
dc.subject | cardiac catheterization | |
dc.subject | elderly adults | |
dc.subject | Cardiology | |
dc.subject | Cardiovascular Diseases | |
dc.subject | Clinical Epidemiology | |
dc.subject | Epidemiology | |
dc.subject | Geriatrics | |
dc.title | Changing Trends in, and Characteristics Associated with, Not Undergoing Cardiac Catheterization in Elderly Adults Hospitalized with ST-Segment Elevation Acute Myocardial Infarction | |
dc.type | Journal Article | |
dc.source.journaltitle | Journal of the American Geriatrics Society | |
dc.source.volume | 63 | |
dc.source.issue | 5 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/faculty_pubs/997 | |
dc.identifier.contextkey | 8734749 | |
html.description.abstract | <p>OBJECTIVES: To describe decade- long trends (1999-2009) in the rates of not undergoing cardiac catheterization and percutaneous coronary intervention (PCI) in individuals aged 65 and older presenting with an ST-segment elevation acute myocardial infarction (STEMI) and factors associated with not undergoing these procedures.</p> <p>DESIGN: Observational population-based study.</p> <p>SETTING: Worcester, Massachusetts, metropolitan area.</p> <p>PARTICIPANTS: Individuals aged 65 and older hospitalized for an STEMI in six biennial periods between 1999 and 2009 at 11 central Massachusetts medical centers (N=960).</p> <p>MEASUREMENTS: Analyses were conducted to examine the characteristics of people who did not undergo cardiac catheterization overall and stratified into two age strata (65-74, > /=75).</p> <p>RESULTS: Between 1999 and 2009, dramatic declines (from 59.4% to 7.5%) were observed in the proportion of older adults who did not undergo cardiac catheterization at all greater Worcester hospitals. These declines were observed in individuals aged 65 to 74 (58.4-6.7%) and in those aged 75 and older (69.4-13.5%). The proportion of individuals not undergoing PCI after undergoing cardiac catheterization decreased from 36.6% in 1999 to 6.5% in 2009. Women, individuals with a prior MI, those with do-not-resuscitate orders, and those with various comorbidities were less likely to have undergone these procedures than comparison groups.</p> <p>CONCLUSION: Older adults who develop an STEMI are increasingly likely to undergo cardiac catheterization and PCI, but several high-risk groups remain less likely to undergo these procedures.</p> | |
dc.identifier.submissionpath | faculty_pubs/997 | |
dc.contributor.department | Department of Medicine, Division of Geriatric Medicine | |
dc.contributor.department | Meyers Primary Care Institute | |
dc.contributor.department | Department of Medicine, Division of Cardiovascular Medicine | |
dc.contributor.department | Department of Quantitative Health Sciences | |
dc.source.pages | 925-31 |