التفاصيل البيبلوغرافية
| العنوان: |
Association Between Functional Status and Use and Effectiveness of Beta-Blocker Prophylaxis in Elderly Survivors of Acute Myocardial Infarction. |
| المؤلفون: |
Vitagliano, Gail, Curtis, Jeptha P., Concato, John, Feinstein, Alvan R., Radford, Martha J., Krumholz, Harlan M. |
| المصدر: |
Journal of the American Geriatrics Society; Apr2004, Vol. 52 Issue 4, p495-501, 7p, 5 Charts |
| مصطلحات موضوعية: |
ADRENERGIC beta blockers, MYOCARDIAL infarction, MEDICAL care for older people, HOSPITAL patients, DISABILITIES, SYMPATHOLYTIC agents |
| مستخلص: |
To examine whether physical and cognitive impairments explain low use of beta-blockers in elderly patients and whether functionally impaired older adults have improved survival if a beta-blocker is prescribed at hospital discharge. Cross-sectional and retrospective cohort study. Acute care hospitals in the United States. National cohort of 45,370 elderly acute myocardial infarction survivors, with no chart-documented contraindications to beta-blocker treatment. The main outcome measures were beta-blocker prescription at hospital discharge and 1-year survival. Fifty percent (n=22,683) of eligible patients were prescribed a beta-blocker at discharge. Older age and functional impairments (incontinence, mobility impairment, and cognitive impairment) were independently associated with decreased use of beta-blockers. The odds ratios for prescribing a beta-blocker at hospital discharge were 0.82 (95% confidence interval (CI)=0.77–0.86), 0.63 (95% CI=0.56–0.71), and 0.40 (95% CI=0.32–0.51) for persons with one, two, and three impairments, respectively, compared with those with no impairments. In survival analysis, patients prescribed a beta-blocker were 21% less likely than nonrecipients to die within 1 year of follow-up (relative risk=0.79, P=.0001). Similar survival benefit was observed in patients with and without functional impairments. This study shows a strong association between functional impairment and the use of beta-blockers after acute myocardial infarction in elderly patients. The results suggest that increasing use of beta-blockers in this group provides an opportunity to improve outcomes. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
