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Characteristics and outcomes in acute myocardial infarction hospitalizations among the older population (age ≥80 years) in the United States, 2004-2018.

Publication ,  Journal Article
Ijaz, SH; Minhas, AMK; Jain, V; Rifai, MA; Sharma, G; Mehta, A; Dani, SS; Fudim, M; Al-Kindi, SG; Sperling, L; Shapiro, MD; Alam, M; Goel, SS ...
Published in: Arch Gerontol Geriatr
August 2023

IMPORTANCE: Acute myocardial infarction (AMI) is a major health concern among older adults (≥80 years). We analyzed a US national database to evaluate the clinical outcomes, resource utilization, and economic burden of AMI hospitalizations in older patients. METHODS AND RESULTS: We analyzed the National Inpatient Sample data between January 2004 and December 2018. We examined the trends of clinical characteristics, inpatient mortality, and healthcare cost utilization in older US adults for AMI hospitalizations. We identified 2,174,587 weighted AMI hospitalizations. There was a decrease in AMI hospitalizations per 100,000 older US adults from 1,679 in 2004 to 1036 in 2018, with a more profound decrease in ST-elevation myocardial infarction (STEMI). We noted an overall increase in comorbidities (hypertension, heart failure, dyslipidemia, atrial fibrillation, diabetes, peripheral vascular disease). Overall, inpatient mortality was 10.6%; adjusted inpatient mortality decreased from 14% in 2004 to 8% in 2018 (p trend <0.001)- consistent across sexes and races. There was increased percutaneous intervention (PCI) utilization [19.3% (2004-2008) to 24.0% (2014-2018)] with a concomitant increase in bleeding and acute kidney injury (AKI). Black adults and women underwent revascularization less frequently than White adults and men. White patients had higher inpatient mortality compared to black patients. There was a decrease in adjusted mean length of stay (LOS) from 6.2 days in 2004 to 3.9 days in 2018 (p trend <0.001). There was an increase in discharge disposition to home with a concomitant decrease in utilization of rehabilitation facilities at discharge. CONCLUSION: Our study showed that the inpatient mortality and LOS has decreased for AMI hospitalizations in the older patient population in the US. While utilization of revascularization strategies has increased, sex and racial disparities exist in the utilization of PCI.

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Published In

Arch Gerontol Geriatr

DOI

EISSN

1872-6976

Publication Date

August 2023

Volume

111

Start / End Page

104930

Location

Netherlands

Related Subject Headings

  • United States
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospitalization
  • Hospital Mortality
  • Geriatrics
 

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Ijaz, S. H., Minhas, A. M. K., Jain, V., Rifai, M. A., Sharma, G., Mehta, A., … Khan, S. U. (2023). Characteristics and outcomes in acute myocardial infarction hospitalizations among the older population (age ≥80 years) in the United States, 2004-2018. Arch Gerontol Geriatr, 111, 104930. https://doi.org/10.1016/j.archger.2023.104930
Ijaz, Sardar Hassan, Abdul Mannan Khan Minhas, Vardhmaan Jain, Mahmoud Al Rifai, Garima Sharma, Anurag Mehta, Sourbha S. Dani, et al. “Characteristics and outcomes in acute myocardial infarction hospitalizations among the older population (age ≥80 years) in the United States, 2004-2018.Arch Gerontol Geriatr 111 (August 2023): 104930. https://doi.org/10.1016/j.archger.2023.104930.
Ijaz SH, Minhas AMK, Jain V, Rifai MA, Sharma G, Mehta A, et al. Characteristics and outcomes in acute myocardial infarction hospitalizations among the older population (age ≥80 years) in the United States, 2004-2018. Arch Gerontol Geriatr. 2023 Aug;111:104930.
Ijaz, Sardar Hassan, et al. “Characteristics and outcomes in acute myocardial infarction hospitalizations among the older population (age ≥80 years) in the United States, 2004-2018.Arch Gerontol Geriatr, vol. 111, Aug. 2023, p. 104930. Pubmed, doi:10.1016/j.archger.2023.104930.
Ijaz SH, Minhas AMK, Jain V, Rifai MA, Sharma G, Mehta A, Dani SS, Fudim M, Al-Kindi SG, Sperling L, Shapiro MD, Alam M, Virani SS, Goel SS, Nasir K, Khan SU. Characteristics and outcomes in acute myocardial infarction hospitalizations among the older population (age ≥80 years) in the United States, 2004-2018. Arch Gerontol Geriatr. 2023 Aug;111:104930.
Journal cover image

Published In

Arch Gerontol Geriatr

DOI

EISSN

1872-6976

Publication Date

August 2023

Volume

111

Start / End Page

104930

Location

Netherlands

Related Subject Headings

  • United States
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospitalization
  • Hospital Mortality
  • Geriatrics