Key result
Poor pre-admission activities of daily living, cardiac arrest, Killip class IV, and anemia were strongly associated with in-hospital death in very elderly patients with acute myocardial infarction.
Why the study?
With an increasing number of elderly patients with AMI receiving primary PCI, the determinants of in-hospital death among patients aged ≥80 years in the current PCI era needed examination.
Observational (n=412)
No
Poor pre-admission activities of daily living, cardiogenic shock, and anemia are strongly associated with in-hospital death among very elderly patients with AMI undergoing PCI.
Answers are grounded in this paper and cite their sources.
May guide risk stratification in very elderly AMI patients undergoing PCI; leaves open whether targeting these factors improves survival.
Since the number of elderly patients suffering from acute myocardial infarction (AMI) has been increasing in developed countries, primary percutaneous coronary intervention (PCI) for the very elderly aged ≥80 years old is already common. The study aimed to examine the determinants of in-hospital death among the very elderly with AMI in current PCI era. We included 412 consecutive AMI patients aged ≥ 80 years old who received PCI to the culprit lesion; however, 42 patients (10.2%) died during the index hospitalization. Thus, univariate and multivariate logistic regression analyses were performed to identify the determinants of in-hospital death. Of note, the modified KATZ index, which is a seven-point scale ranging from 0 to 6 (0 point indicating no dependence and six points indicating full dependence), was calculated to evaluate pre-admission activity of daily living (ADL). In multivariate analysis, cardiac arrest (OR 4.642, 95% CI 1.177-18.305, P = 0.028), Killip class IV (versus Killip class I: OR 5.732, 95% CI 1.076-16.630, P = 0.001), modified KATZ index (OR 1.212, 95% CI 1.001-1.469, P = 0.049), hemoglobin levels (OR 0.803, 95% CI 0.656-0.983, P = 0.033), use of temporary pacemaker (OR 2.603, 95% CI 1.010-6.709, P = 0.048), final Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 (versus TIMI ≤ 2: OR 0.240, 95% CI 0.093-0.618, P = 0.003), and mechanical circulatory support (OR 4.264, 95% CI 1.818-10.005, P = 0.001) were found to be significantly associated with in-hospital death. In conclusion, in-hospital outcomes of the very elderly with AMI were still poor in the current PCI era. Poor pre-admission ADL as well as cardiogenic shock and anemia were determined to be strongly associated with in-hospital death.
No takes yet. Share an insight, caveat, or question.
Seguchi et al. (2020) conducted an observational in Acute Myocardial Infarction (n=412). Poor pre-admission activities of daily living (modified KATZ index) vs. Better pre-admission activities of daily living was evaluated on In-hospital death (OR 1.212, 95% CI 1.001-1.469, p=0.049). Poor pre-admission activities of daily living, cardiac arrest, Killip class IV, and anemia were strongly associated with in-hospital death in very elderly patients with acute myocardial infarction.
Synapse has enriched 10 related papers. Consider them for comparative context: