Management of Myocardial Infarction in the Elderly: Referral and Outcome on a Coronary Care Unit (CCU)

Haigh, R A; Woods, K. L.; Fletcher, Simon; Bowns, Ian

doi:10.1093/ageing/19.suppl_2.p19-b

Cited by 4 publications

(5 citation statements)

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“…Data for the remaining utility values are taken from the Harvard utilities database 32,[36][37][38][39][40][41][42] . The various studies used to inform the individual utility values provide central estimates or values to define the possible range of varia tion.…”

Section: Utility Input Parametersmentioning

confidence: 99%

Modelling the long term cost effectiveness of clopidogrel for the secondary prevention of occlusive vascular events in the UK

Karnon

Brennan

Pandor

et al. 2004

Current Medical Research and Opinion

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Section: Utility Input Parametersmentioning

confidence: 99%

Modelling the long term cost effectiveness of clopidogrel for the secondary prevention of occlusive vascular events in the UK

Karnon

Brennan

Pandor

et al. 2004

Current Medical Research and Opinion

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“…1 The advent of thrombolytic therapy has reinforced this sense of urgency. A recent study 2 has shown that despite the undeniable benefit of thrombolytic therapy, 3 approximately 50% of patients with acute myocardial infarction, particularly those over 65 years of age, still take over 3.5 hours to be admitted.…”

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confidence: 99%

Factors delaying hospital admission after stroke in Leicestershire.

Harper

Haigh

Potter

et al. 1992

Stroke

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Background and Purpose: Use of thrombolysis and acute treatments for cerebral infarction may require that acute stroke be treated as a medical emergency. To assess the factors influencing the time to admission in acute stroke, we conducted a prospective study of all such patients admitted to the hospitals in Leicester, UK, over a 12-month period.Methods: Factors assessed were age, sex, time of stroke onset, stroke severity, home circumstances, and routes of admission. Initial between-group comparisons were made with the Mann-Whitney U test. The individual contribution of each of these variables was assessed with multiple linear regression analysis.Results

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“…However, there remains a reluctance in many hospitals to promote equal availability of thrombolytic treatment to elderly patients presenting with acute MI — indeed, the imposition of age‐related policies selectively discriminating against the elderly denies many patients potentially life‐saving treatment, and these policies are difficult to justify. Where thrombolytic policies do offer unrestricted access to the elderly, greater median time delays from onset of symptoms to thrombolysis 9 and low rates of thrombolysis have still been reported, 11 , 12 and most authorities still consider that more elderly patients who present with acute MI should receive thrombolytic therapy 13 …”

Section: Discussionmentioning

confidence: 99%

“…Preference on many CCUs may be given to younger patients possibly on the assumption of a potentially greater prolongation of life in those receiving thrombolytic treatment. However, economic analysis has shown the cost of thrombolytic treatment with streptokinase to be lower, per quality adjusted life year, in elderly than younger patients 9 …”

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confidence: 99%

Varying Thrombolytic Administration Rates in Elderly Patients With Acute Myocardial Infarction

Farnsworth

1993

Int J Clinical Practice

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SUMMARY Receipt of thrombolytic therapy in patients aged 75 or over with proven acute myocardial infarction admitted initially to either the coronary care unit (CCU) or a geriatric medical ward (GMW) was studied retrospectively in a hospital administering thrombolysis only in the CCU. Mean age and age distribution of patients admitted to each unit initially showed no significant difference. Of 50 patients admitted directly to the CCU, 28 (56%) received thrombolysis, compared with 13 of 50 (26%) GMW admissions (P<0.02). Of 37 GMW admissions, 14 (38%) failed to receive thrombolysis without documented contraindication compared with 2 of 22 (9%) CCU admissions (P<0.05). Aspirin was administered in 39 (78%) CCU and 31 (62%) GMW admissions (P<0.05). Non‐administration of aspirin without apparent contraindication occurred in 3 of 11 (27%) compared with 8 of 19 (42%) GMW admissions (NS). Elderly patients thus failed to receive thrombolytic therapy as a result of initial admission to a unit unable to administer this treatment.

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Management of Myocardial Infarction in the Elderly: Referral and Outcome on a Coronary Care Unit (CCU)

Cited by 4 publications

References 0 publications

Modelling the long term cost effectiveness of clopidogrel for the secondary prevention of occlusive vascular events in the UK

Modelling the long term cost effectiveness of clopidogrel for the secondary prevention of occlusive vascular events in the UK

Factors delaying hospital admission after stroke in Leicestershire.

Varying Thrombolytic Administration Rates in Elderly Patients With Acute Myocardial Infarction

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