Primary Angioplasty in Acute Myocardial Infarction: Does Age or Race Matter?

Regueiro, Carol; Gill, Nikita; Hart, Alison R.; Crawshaw, Linda; Hentosz, Teresa; Shannon, Richard P.

doi:10.1023/b:thro.0000003326.00180.60

Cited by 15 publications

(16 citation statements)

References 31 publications

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“…These results were consistent with previous studies suggesting that older age, 1,[6][7][8] female gender, [9][10][11][12] and dementia 13) are factors inversely related to the use of invasive procedures including PCI. Increased ADL impairment in the patients without emergency PCI may have been due to the greater age of this subgroup.…”

Section: Discussionsupporting

confidence: 83%

Effect of Emergency Percutaneous Coronary Intervention on In-Hospital Mortality of Very Elderly (80+ Years of Age) Patients With Acute Myocardial Infarction

et al. 2006

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SUMMARYIt is still controversial whether percutaneous coronary intervention (PCI) is effective in improving in-hospital survival in very elderly patients. Therefore, using data from the Tokai Acute Myocardial Infarction Study II, we studied the effect of emergency PCI on the in-hospital mortality of very elderly (80+ years of age) patients with acute myocardial infarction (AMI). The study was a prospective study of all consecutive patients admitted to the 15 acute care hospitals in the Tokai region with the diagnosis of AMI from 2001 to 2003. A total of 211 patients undergoing emergency PCI and 176 patients not undergoing PCI were included in the present analysis. We compared the baseline and procedural characteristics and the clinical outcomes between the 2 groups. Patients without emergency PCI were older and had an increased prevalence of female gender, ADL impairment, and dementia in comparison with those with PCI. They also showed poorer clinical conditions. They were less likely to be transferred to intensive care or coronary care units and to be given intra-aortic balloon pumps. The patients with emergency PCI had nearly one-third the in-hospital mortality rate of the patients without emergency PCI. According to multivariate analysis, emergency PCI was still identified as an independent predictor of in-hospital death, with an adjusted odds ratio of 0.26 (95% CI, 0.07-0.97). The results indicated that emergency PCI has a preventative effect on in-hospital mortality in Japanese AMI patients 80 years of age and older. (Int Heart J 2006; 47: 663-669)

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Section: Discussionsupporting

confidence: 83%

Effect of Emergency Percutaneous Coronary Intervention on In-Hospital Mortality of Very Elderly (80+ Years of Age) Patients With Acute Myocardial Infarction

et al. 2006

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“…This latter result may seem surprising because older patients are generally in poorer health. Actually, this is due to the fact that they receive fewer procedures, a fact that is well documented in the medical literature [34,35]. The estimation of an incomplete specification using only individual patient characteristics X 0 i;h;t as explanatory variables reveals that 54.2% of cost variability can be explained by observable patient heterogeneity.…”

Section: Resultsmentioning

confidence: 96%

The sources of hospital cost variability

Dormont

Milcent

2004

Health Economics

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Hospital heterogeneity is a major issue in defining a reimbursement system. If hospitals are heterogeneous, it is difficult to distinguish which part of the differences in costs is due to cost containment efforts and which part cannot be reduced, because it is due to other unobserved sources of hospital heterogeneity. In this paper, we apply an econometric approach to analyse hospital cost variability. We use a nested three-dimensional database (stays-hospitals-years) in order to explore the sources of variation in hospital costs, taking into account unobservable components of hospital cost heterogeneity. The three-dimensional structure of our data makes it possible to identify transitory and permanent components of hospital cost heterogeneity. Econometric estimates are performed on a sample of 7314 stays for acute myocardial infarction (AMI) observed in 36 French public hospitals over the period 1994-1997. Transitory unobservable hospital heterogeneity is far from negligible: its estimated standard error is about 50% of the standard error we estimate for cost variability due to permanent unobservable heterogeneity between hospitals.

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“…Age-related differences in the quality of care have also been reported within other medical specialities [10][11][12][13][14][15]. The phenomenon is commonly referred to as 'ageism'.…”

Section: Discussionmentioning

confidence: 94%

Older patients with acute stroke in Denmark: quality of care and short-term mortality. A nationwide follow-up study

et al. 2007

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Primary Angioplasty in Acute Myocardial Infarction: Does Age or Race Matter?

Abstract: Our results indicate differences in the use of PA in the elderly and African-Americans. These differences are not explained by severity of illness and suggest that interventions and standard therapies may be withheld from those who may benefit most.

Cited by 15 publications

References 31 publications

Effect of Emergency Percutaneous Coronary Intervention on In-Hospital Mortality of Very Elderly (80+ Years of Age) Patients With Acute Myocardial Infarction

Effect of Emergency Percutaneous Coronary Intervention on In-Hospital Mortality of Very Elderly (80+ Years of Age) Patients With Acute Myocardial Infarction

The sources of hospital cost variability

Older patients with acute stroke in Denmark: quality of care and short-term mortality. A nationwide follow-up study

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