Nursing home admission after myocardial infarction in the elderly: A nationwide cohort study

Abstract

BackgroundData on nursing home admission after myocardial infarction (MI) in the elderly are scarce. We investigated nursing home admission within 6 months and 2 years after MI including predictors for nursing home admission in a nationwide cohort of elderly patients.MethodsUsing Danish nationwide registries, we identified all subjects 65 years or older residing at home who were discharged following first-time MI in the period 2008–2015. We determined sex- and age-stratified incidence rates per 1000 person years (IRs) and incidence rate ratios (IRRs) of nursing home admissions using Poisson regression models compared to the Danish population 65 years or older with no prior MI. Poisson regression models were also applied to identify predictors of nursing home admission.ResultsThe 26,539 patients who were discharged after MI had a median age of 76 (quartile 1-quartile 3: 70–83) years. The IRs of nursing home admission after MI increased with increasing age and for 80-84-year-old women IRs after 6 months and 2 years were 113.9 and 62.9, respectively, compared to 29.4 for women of the same age with no prior MI. The IRs for 80-84-year-old men after MI were 56.0 and 36.2, respectively, compared to 24.3 for men of the same age with no prior MI. In adjusted analyses the 6 months and 2 years IRRs for 80-84-year-old subjects were 2.56 (95% CI 2.11–3.10) and 1.41 (95% CI 1.22–1.65) for women and 1.74 (95% CI 1.34–2.25) and 1.05 (95% CI 0.88–1.26) for men, respectively. Predictors were advanced age, dementia, home care, Parkinson’s disease, cerebrovascular disease, living alone, depression, and arrhythmia.ConclusionIn elderly patients discharged following first-time MI, the risk of subsequent nursing home admission within 6 months was 2-fold higher compared to an age-stratified population with no prior MI. After 2 years this risk remained higher in women.

Use of health and aged care services in Australia following hospital admission for myocardial infarction, stroke or heart failure

“…However, the existing scientific literature on the likelihood of entering residential care following MI and HF varies. Similar to our findings, a study using Danish nationwide registries (n = 26,539) showed older patients (65+ years) discharged following MI hospitalization compared with all other hospitalization were at an increased likelihood of subsequent residential care admission [7]. Likewise, a Finnish study using linked health administrative datasets (n = 301,263) also showed older patients (65+ years) were at an increased likelihood of entering residential care following hospitalization due to heart disease, including both MI and HF [8].…”

“…It is well known that stroke survivors in the older population are at an increased likelihood of being admitted directly to residential care at the time of hospital discharge [6]. Some studies have also suggested that there is an increased likelihood of residential care admission following MI or HF-related hospitalization [7][8][9]. Likewise, exacerbations and complications associated with MI, stroke and HF are common, and may result in rehospitalization [10][11][12].…”

Mortality following first-time hospitalization with acute myocardial infarction in Norway, 2001–2014: Time trends, underlying causes and place of death

“…Our group has previously shown that the proportion of elderly surviving an AMI episode is increasing over time [2]. A recent publication from Denmark showed that the risk of being admitted to a nursing home after surviving an incident AMI is twice as high compared to general population of the same age [27]. Further, as the threshold for admittance to nursing homes has increased, their population is becoming more physically and cognitively frail [28].…”

Patient Adherence to Therapy After Myocardial Infarction: A Scoping Review

“…12 One study was conducted using a retrospective design (analysis of national stationary sample databases) 13 and the other study was a cohort design based on a nationwide registry. 14…”

“…18 Two studies conducted retrospective researches using National Patient Registration System to investigate predictors and risk of hospitalization in elderly patients after MI with the aim of subsequently improving adherence to therapy. [12][13][14]…”