MedStar Authors catalog › Details for: Comparison of Outcomes After Percutaneous Coronary Interventions in Patients of Eighty Years and Above Compared With Those Less Than 80 Years.
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Comparison of Outcomes After Percutaneous Coronary Interventions in Patients of Eighty Years and Above Compared With Those Less Than 80 Years.

by Pacha, Homam Moussa.
Citation: ; American Journal of Cardiology. 124(9):1372-1379, 2019 11 01..Journal: The American journal of cardiology.Published: ; 2019; ; ISSN: 0002-9149.Full author list: Al-Khadra Y; Alraies MC; Bagur R; Darmoch F; Garcia S; Glazier JJ; Idris A; Kabach A; Kajy M; Kaki A; Kapadia S; Kwok CS; Mamas M; Pacha HM.UI/PMID: 31500819.Subject(s): Age Factors | United States/ep [Epidemiology] | Risk Factors | *Risk Assessment/mt [Methods] | Retrospective Studies | *Postoperative Complications/ep [Epidemiology] | *Percutaneous Coronary Intervention/ae [Adverse Effects] | Middle Aged | Male | Humans | Hospital Mortality/td [Trends] | *Forecasting | Follow-Up Studies | Female | *Coronary Artery Disease/su [Surgery] | Aged, 80 and over | AgedInstitution(s): MedStar Washington Hospital CenterDepartment(s): Medicine/Internal MedicineActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1016/j.amjcard.2019.07.055 (Click here) Abbreviated citation: ; Am J Cardiol. 124(9):1372-1379, 2019 11 01.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Life expectancy in the United States has increased due to advances in health care. Despite increased utilization of percutaneous coronary intervention (PCI), octogenarian patients are less likely to be referred to the catheterization laboratory for coronary interventions. This is in part due to multiple patient co-morbidities and lack of established guidelines. We examined in-hospital clinical outcomes of octogenarian and nonoctogenarian patients who underwent PCI in the United States. Using the National Inpatient Sampling database, we identified all adult patients who are older than 18 years and underwent PCI. Patient were stratified by age into 2 groups, >=80 years old and <80 years old and in-hospital adverse outcome rates were determined. A total of 11,056,559 patients underwent PCI between the years of 2002 and 2014 and 1,544,563 patients were >=80 years old (14%). After multivariable adjustment, patients who are >=80 years old had higher in-hospital mortality (3.3% vs 1.3%, adjusted Odds Ratio, 1.624; 95% confidence interval, 1.602 to 1.647, p <0.0001) and longer length of stay (median length of stay days 3, range 2 to 8 days vs median 2 days, range 1 to 4 days) (p <0.0001). Patients >=80 years old had a higher rate of cardiopulmonary complications, postprocedural stroke, acute kidney injury, postprocedural thromboembolic complications, and hemorrhage requiring transfusion. There was no difference in vascular complications between the 2 groups. In conclusion, octogenarians who underwent PCI were at increased risk for in-hospital mortality and morbidity compared with nonoctogenarians. The decision to proceed with PCI in this patient population should be individualized, taking into consideration known risk factors and patient's wishes. Copyright (c) 2019. Published by Elsevier Inc.

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