Risk Stratification in Older Patients With Acute Myocardial Infarction: Physicians' Perspectives.

Journal Article (Journal Article)

OBJECTIVE: Risk stratification models support clinical decision making in acute myocardial infarction (AMI) care. Existing models were developed using data from younger populations, potentially limiting accuracy and relevance in older adults. We describe physician-perceived risk factors, views of existing models, and preferences for future model development in older adults. METHOD: Qualitative study using semi-structured telephone interviews and the constant comparative method. RESULTS: Twenty-two physicians from 14 institutions completed the interviews. Median age was 37, and median years of clinical experience was 11.5. Perceived predictors included cardiovascular, comorbid, functional, and social risk factors. Physicians viewed models as easy to use, yet neither inclusive of risk factors nor predictive of non-mortality outcomes germane to clinical decision making in older adults. Ideal models included multidimensional risk domains and operational requirements. DISCUSSION: Physicians reported limitations of available risk models when applied to older adults with AMI. New models are needed to guide AMI treatment in this population.

Full Text

Duke Authors

Cited Authors

  • Feder, SL; Schulman-Green, D; Dodson, JA; Geda, M; Williams, K; Nanna, MG; Allore, HG; Murphy, TE; Tinetti, ME; Gill, TM; Chaudhry, SI

Published Date

  • April 2016

Published In

Volume / Issue

  • 28 / 3

Start / End Page

  • 387 - 402

PubMed ID

  • 26100619

Pubmed Central ID

  • PMC4886275

Electronic International Standard Serial Number (EISSN)

  • 1552-6887

Digital Object Identifier (DOI)

  • 10.1177/0898264315591005

Language

  • eng

Conference Location

  • United States