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dc.contributor.authorAli, Omar
dc.contributor.authorSadiq, Immad
dc.contributor.authorGoldberg, Robert J.
dc.contributor.authorYarzebski, Jorge L.
dc.contributor.authorLessard, Darleen M.
dc.contributor.authorGurwitz, Jerry H.
dc.contributor.authorGore, Joel M.
dc.date2022-08-11T08:10:38.000
dc.date.accessioned2022-08-23T17:15:23Z
dc.date.available2022-08-23T17:15:23Z
dc.date.issued2003-03-26
dc.date.submitted2010-05-27
dc.identifier.citationJ Thromb Thrombolysis. 2002 Aug;14(1):5-14.
dc.identifier.issn0929-5305 (Linking)
dc.identifier.pmid12652145
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47156
dc.description.abstractBACKGROUND: Relatively limited information is available about recent, and trends over time, use of thrombolytic therapy in patients of different ages hospitalized with acute myocardial infarction and the association between use of thrombolytic therapy and hospital outcomes. METHODS: We conducted an observational study of 5601 residents of the Worcester, Massachusetts, metropolitan area (1990 census = 437,000) with confirmed acute myocardial infarction in all local hospitals during 6 one-year periods between 1990 and 1999. RESULTS: Despite relatively stable use of thrombolytic therapy between 1990 and 1995, decreases in the use of thrombolytic therapy in all patients with acute myocardial infarction were observed in 1997 and 1999. There was a 1.6 fold decrease in the use of thrombolytic therapy between 1990 and 1999 in patients <65 years. Patients 65-74 years (33.7% 1990; 11.7% 1999) and those 75 years and older (10.8% 1990; 6.7% 1999) experienced marked decreases in the receipt of thrombolytic therapy over time. Use of thrombolytic therapy was associated with reduced hospital mortality in each of the four age-specific groups under study (<55, 55-64, 65-74, > or =75) through the degree of benefit on hospital death rates associated with the use of thrombolytic therapy was attenuated after adjustment for additional confounders. CONCLUSIONS: Our findings indicate recent declines in the use of thrombolytic therapy in middle-aged and elderly patients with acute myocardial infarction. The impact of thrombolytic therapy on hospital outcomes was observed in each of our age strata under study though the magnitude of absolute and relative benefit varied according to age.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=12652145&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1023/A:1022041019511
dc.subjectAge Distribution
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAging
dc.subjectFemale
dc.subject*Hospitalization
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMyocardial Infarction
dc.subjectRegression Analysis
dc.subjectResidence Characteristics
dc.subject*Thrombolytic Therapy
dc.subjectTreatment Outcome
dc.subjectBioinformatics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleAge-specific differences in the use of thrombolytic therapy and hospital outcomes in patients with acute myocardial infarction: a community-wide perspective
dc.typeJournal Article
dc.source.journaltitleJournal of thrombosis and thrombolysis
dc.source.volume14
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/305
dc.identifier.contextkey1333058
html.description.abstract<p>BACKGROUND: Relatively limited information is available about recent, and trends over time, use of thrombolytic therapy in patients of different ages hospitalized with acute myocardial infarction and the association between use of thrombolytic therapy and hospital outcomes.</p> <p>METHODS: We conducted an observational study of 5601 residents of the Worcester, Massachusetts, metropolitan area (1990 census = 437,000) with confirmed acute myocardial infarction in all local hospitals during 6 one-year periods between 1990 and 1999.</p> <p>RESULTS: Despite relatively stable use of thrombolytic therapy between 1990 and 1995, decreases in the use of thrombolytic therapy in all patients with acute myocardial infarction were observed in 1997 and 1999. There was a 1.6 fold decrease in the use of thrombolytic therapy between 1990 and 1999 in patients <65 years. Patients 65-74 years (33.7% 1990; 11.7% 1999) and those 75 years and older (10.8% 1990; 6.7% 1999) experienced marked decreases in the receipt of thrombolytic therapy over time. Use of thrombolytic therapy was associated with reduced hospital mortality in each of the four age-specific groups under study (<55, 55-64, 65-74, > or =75) through the degree of benefit on hospital death rates associated with the use of thrombolytic therapy was attenuated after adjustment for additional confounders.</p> <p>CONCLUSIONS: Our findings indicate recent declines in the use of thrombolytic therapy in middle-aged and elderly patients with acute myocardial infarction. The impact of thrombolytic therapy on hospital outcomes was observed in each of our age strata under study though the magnitude of absolute and relative benefit varied according to age.</p>
dc.identifier.submissionpathqhs_pp/305
dc.contributor.departmentDepartment of Medicine, Division of Geriatric Medicine
dc.contributor.departmentMeyers Primary Care Institute
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.source.pages5-14


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