Quality Indicators for the Care of Ischemic Heart Disease in Vulnerable Elders

Watson, Karol E.; Fung, Constance H.; Budoff, Matthew J.

doi:10.1111/j.1532-5415.2007.01344.x

Cited by 13 publications

(5 citation statements)

References 61 publications

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“…53 The critical issue is that patients with MCI receive the care that they would want if properly informed. Despite clinical practice guidelines 25 and the benefits on mortality and physical function, our results suggest that patients with MCI get coronary revascularization less often. Our results also suggest that cardiac rehabilitation remains underused in older adults with normal cognition or MCI.…”

Section: Discussioncontrasting

confidence: 59%

“…18,19 Large, randomized, controlled trials and meta-analyses have shown that both early cardiac catheterization with appropriate coronary revascularization [20][21][22] and cardiac rehabilitation 23,24 reduce mortality and improve physical function after AMI. Current clinical guidelines 25 recommend that all vulnerable elders, except those with advanced dementia or limited life expectancy, receive these effective treatments. It is unknown whether patients with pre-existing MCI are less likely than patients with normal cognition to receive invasive therapies like cardiac catheterization and revascularization, or postacute, non-invasive services like cardiac rehabilitation, after AMI.…”

Section: Introductionmentioning

confidence: 99%

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Mild Cognitive Impairment and Receipt of Treatments for Acute Myocardial Infarction in Older Adults

et al. 2019

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BACKGROUND: Older adults with mild cognitive impairment (MCI) should receive evidence-based treatments when indicated. Providers and patients may overestimate the risk of dementia in patients with MCI leading to potential under-treatment. However, the association between pre-existing MCI and receipt of evidence-based treatments is uncertain. OBJECTIVE: To compare receipt of treatments for acute myocardial infarction (AMI) between older adults with pre-existing MCI and cognitively normal patients. DESIGN: Prospective study using data from the nationally representative Health and Retirement Study, Medicare, and American Hospital Association. PARTICIPANTS: Six hundred nine adults aged 65 or older hospitalized for AMI between 2000 and 2011 and followed through 2012 with pre-existing MCI (defined as modified Telephone Interview for Cognitive Status score of 7-11) and normal cognition (score of 12-27). MAIN MEASURES: Receipt of cardiac catheterization and coronary revascularization within 30 days and cardiac rehabilitation within 1 year of AMI hospitalization. KEY RESULTS: Among the survivors of AMI, 19.2% had pre-existing MCI (55.6% were women and 44.4% were male, with a mean [SD] age of 82.3 [7.5] years), and 80.8% had normal cognition (45.7% were women and 54.3% were male, with a mean age of 77.1 [7.1] years). Survivors of AMI with pre-existing MCI were significantly less likely than those with normal cognition to receive cardiac catheterization (50% vs 77%; P < 0.001), coronary revascularization (29% vs 63%; P < 0.001), and cardiac rehabilitation (9% vs 22%; P = 0.001) after AMI. After adjusting for patient and hospital factors, pre-existing MCI remained associated with lower use of cardiac catheterization (adjusted hazard ratio (aHR), 0.65; 95% CI, 0.48-0.89; P = 0.007) and coronary revascularization (aHR, 0.55; 95% CI, 0.37-0.81; P = .003), but not cardiac rehabilitation (aHR, 1.01; 95% CI, 0.49-2.07; P = 0.98). CONCLUSIONS: Pre-existing MCI is associated with lower use of cardiac catheterization and coronary revascularization but not cardiac rehabilitation after AMI.

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Section: Discussioncontrasting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Mild Cognitive Impairment and Receipt of Treatments for Acute Myocardial Infarction in Older Adults

et al. 2019

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“…Five studies conducted by cardiovascular societies or a government agency used a consensus-making process, based on their original protocols [ 12 , 21 , 23 , 31 ]. Furthermore, four studies used expert panel consensus through discussion [ 21 , 27 , 31 , 33 ]. We identified 268 QIs in the 18 evaluates articles, including the duplications between them: 191 QIs for ACS, 57 QIs for AHF, and 20 QIs for AAD.…”

Section: Resultsmentioning

confidence: 99%

Quality indicators for acute cardiovascular diseases: a scoping review

Kanaoka

Iwanaga

Tsujimoto³

et al. 2022

BMC Health Serv Res

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Background Although many quality indicator (QI) sets have been developed for acute cardiovascular diseases, a comprehensive summary is lacking. In this scoping review we aimed to summarize the available evidence on the QI sets for acute cardiovascular diseases, and assess the QI set development process. We followed the Joanna Briggs Institute framework and the PRISMA extension for scoping reviews. Methods We conducted a systematic search of MEDLINE, EMBASE, and major international guidelines on QIs for acute major cardiovascular diseases. The study included articles published after 2000. Results Among the 3112 articles screened, 18 were included in this scoping review. Among the 18 articles included, 12 were on acute coronary syndrome (ACS), five on acute heart failure (AHF), and two on acute aortic dissection (AAD); one article included QIs for both ACS and AHF. Only four of these studies conducted a systematic search with a search strategy. From the 18 articles, 268 QIs containing duplication between articles were identified (191 QIs were for ACS, 57 were for AHF, and 20 were for AAD) and QI measurements varied across articles. Conclusions This scoping review provides a comprehensive list of QIs for acute cardiovascular diseases. Our results may be helpful to clinicians and organizations seeking to develop QIs for acute cardiovascular care in the future.

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“…However, the authors of the review conducted by Groene et al (2008) included both quality indicators as well as PSIs and limited the search to a specific setting. None of the previously conducted reviews resulted in a similar number of PSIs (close to 3,000) and contained all mentioned categories (Shahangian and Snyder 2009;Groene et al 2008;Sachverständigenrat Gesundheit 2007;Watson et al 2007). …”

Section: Discussionmentioning

confidence: 95%

“…In other reviews, the same approach has been chosen (Shahangian and Snyder 2009;Groene et al 2008;Sachverständigenrat Gesundheit 2007;Watson et al 2007). Selection bias is possible because no other databases, e.g., those with focus on nursing professions, were used and only a sample of international institutions was investigated.…”

Section: Limitationsmentioning

confidence: 99%

Patient-safety indicators: a systematic review, criteria-based characterization and prioritization

et al. 2012

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Objective To identify and classify internationally published and applied patient safety indicators (PSIs) and their caracterization as a subgroup of quality indicators. Prioritizing PSIs considering the need for action on patient safety of the German health care and their validation by applying scientific quality criteria. Methods A systematic review of publications indexed from January 2000 to December 2009 was conducted using Medline and websites of institutions. PSIs were characterized as a subgroup of quality indicators by defined criteria and prioritized using a criteria-based procedure.Results A total of 2,973 PSIs were identified and classified in a PSI-database. A Medline search resulted in 1,568 PSIs and 1,405 PSIs were identified by analyzing indicator sets of institutions. Finally, 60 PSIs were the result of prioritizing and validating the search outcomes. Discussion The characterization of PSIs and the criteriabased instrument were suitable to identify appropriate PSIs, so that they can be validated later on using a Delphimethod and a pilot and can be eventually implemented into practice.

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Quality Indicators for the Care of Ischemic Heart Disease in Vulnerable Elders

Cited by 13 publications

References 61 publications

Mild Cognitive Impairment and Receipt of Treatments for Acute Myocardial Infarction in Older Adults

Mild Cognitive Impairment and Receipt of Treatments for Acute Myocardial Infarction in Older Adults

Quality indicators for acute cardiovascular diseases: a scoping review

Patient-safety indicators: a systematic review, criteria-based characterization and prioritization

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