Abstract:
OBJECTIVES:To investigate the cause of worse survival in older patients after myocardial infarction (MI). DESIGN:Prospective 18-month and longer follow-up study of a cohort of 167 patients (mean age +/- standard deviation 58 +/- 12, including 71 aged >or=65) with acute MI for cardiac events, defined as cardiac death, recurrent MI, or resuscitated ventricular tachycardia or fibrillation (VT/VF). SETTING:Milwaukee County Medical Complex and the Zablocki Veterans Affairs Medical Center, Milwaukee, WI. PARTICIPANTS:One hundred sixty-seven patients who underwent dobutamine-atropine stress echocardiography (DASE) in the first week (2-7 days) after acute MI and were medically managed. MEASUREMENTS:Comparison of event rates in older (>or=65 years) and younger (<65 years) patients and of clinical, resting echocardiographic, DASE, and angiographic findings in patients with and without events. Coronary angiography was performed in 141. RESULTS:Older and younger patients tolerated DASE well. During follow-up, there were 29 cardiac events (cardiac death in 17, nonfatal MI in 10, and VT/VF in 2). Events were more common in older patients (26% vs 12%, P <.05), especially death (19% vs 5%, P <.05). Scar size in the infarct zone by DASE was larger (4.0 +/- 2.8 vs 3.0 +/- 2.7 segments, P <.05) and remote wall motion abnormalities more common (47 vs 29%, P <.05) in older patients. Univariate determinants of outcome (P <.05) in older patients were diabetes mellitus; remote wall motion abnormalities; angiographic multivessel disease; scar size; ejection fraction; and resting, low-, and peak-dose wall motion score. Univariate determinants in younger patients were similar, but diabetes mellitus was not. Multivariate analysis revealed that remote wall motion abnormalities and scar size by DASE were independently predictive of outcome in older and younger patients and diabetes mellitus only in older patients. Low- and peak-dose DASE data enhanced (P <.01) the prediction of outcome in all patients with acute MI relative to clinical data and resting echocardiography. CONCLUSION:DASE was more predictive of outcome than clinical data and resting echocardiography in both age groups. Scar size and remote wall motion abnormalities were the primary determinants of outcome irrespective of age. The worse prognosis of older patients correlated with diabetes mellitus, greater scar size, and higher incidence of remote inducible ischemia.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Smart S,Sagar K,Tresch Ddoi
10.1046/j.1532-5415.2002.t01-1-50302.xsubject
Has Abstractpub_date
2002-07-01 00:00:00pages
1176-85issue
7eissn
0002-8614issn
1532-5415pii
jgs50302journal_volume
50pub_type
杂志文章abstract:OBJECTIVES:To examine current utilization patterns of cholinesterase inhibitor (ChEI) therapy for dementia to determine treatment duration, use in long-term care, how often patients receive these drugs until death, and frequency of switching between the available ChEIs. DESIGN:A population-based healthcare administrat...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2007.01377.x
更新日期:2007-10-01 00:00:00
abstract::Our objective was to determine the outcome of onsite CPR in elderly patients receiving institutional care who had access to 24-hour on-site full ACLS capability. We used a retrospective chart and CPR protocol review of all patients who received CPR during the study period; these were patients or residents in a multi-l...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb02052.x
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:We evaluated prospectively the use of acute hemodialysis among hospitalized patients to identify demographic and clinical predictors of and chart documentation concerning dialysis withheld and withdrawn. DESIGN:Prospective cohort study. SETTING:Five teaching hospitals. PATIENTS:Five hundred sixty-five seri...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/j.1532-5415.2000.tb03145.x
更新日期:2000-05-01 00:00:00
abstract::Since 2012, the American Geriatrics Society (AGS) has also been collaborating with the American Board of Internal Medicine (ABIM) Foundation, joining its "Choosing Wisely" campaign on two separate lists of Five Things Healthcare Providers and Patients Should Question. The campaign is designed to engage healthcare orga...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.12770
更新日期:2014-05-01 00:00:00
abstract::Chronic atrial fibrillation is generally thought to cause stroke by atrial thrombus formation with subsequent embolization. Rheumatic heart disease previously led to most cases of atrial fibrillation, but recent substantial declines in the incidence of rheumatic fever have changed the distribution of causes of atrial ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb07121.x
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:The Health Care Surrogate Act (HCSA) in Illinois has been proposed as a model for state laws naming surrogate medical decision-makers for those without advance directives (ADs). Our objective was to determine if the HCSA identifies the same surrogate as older persons would choose for themselves. If not, is th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb02437.x
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVES:To examine the extent to which elderly individuals use various skilled care facilities after coronary artery bypass grafting (CABG). DESIGN:Retrospective cohort study. SETTING:State of Michigan from 1997 to 1998. PARTICIPANTS:Residents aged 65 and older enrolled in Medicare who underwent CABG. MEASUREMEN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53356.x
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVES:To determine the proportion of older people with diabetes mellitus (DM) eligible to enroll in the standard Medicare Part D drug benefit who will exceed the initial $2,250 coverage limit and to determine the effect of hypoglycemic choice on risk of exceeding the coverage limit. DESIGN:Cross-sectional survey....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2006.00663.x
更新日期:2006-04-01 00:00:00
abstract::The objectives of this study were to examine the prevalence of assistive technology (AT) use, type of assistance used for each activity of daily living (ADL) limitation, and correlates of AT use among Native Indian aged 55 and older. Data were collected as part of a cross-sectional study of disability with 505 members...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.03140.x
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:To compare the efficacy and safety of ertapenem, 1 g once a day, with ceftriaxone, 1 g once a day, for treatment of the subgroup of patients aged 65 and older with community-acquired pneumonia (CAP) requiring parenteral therapy. DESIGN:Combined data from patients aged 65 and older in two randomized, double-...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1532-5415.2003.51507.x
更新日期:2003-11-01 00:00:00
abstract::Given the American Geriatrics Society's (AGS) commitment to improving health care for older adults by, among other means, educating older people and their caregivers about their health and healthcare choices, the AGS was delighted when, in late 2011, the American Board of Internal Medicine Foundation invited the Socie...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12226
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:To investigate mortality risk and survival time in new-incident cases of cognitive impairment (CI) in old age. DESIGN:Prospective cohort study in six German cities. SETTING:German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). PARTICIPANTS:Two thousand eighty-nine nondemented...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.14666
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:To understand the natural history of frailty after an aggressive surgical intervention, kidney transplantation (KT). DESIGN:Prospective cohort study (December 2008-March 2014). SETTING:Baltimore, Maryland. PARTICIPANTS:Kidney transplantation recipients (N = 349). MEASUREMENTS:The Fried frailty score was ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13657
更新日期:2015-10-01 00:00:00
abstract::Although experiences of racism in day-to-day life may affect minority patients' interaction with the health system and may influence health outcomes, little is known about these experiences in patients with chronic diseases. The goal of this study was to explore the frequency and correlates of perceived societal racis...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2005.00501.x
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVES:To determine, in a sample of Ashkenazi Jewish aged 95 and older, whether there is a compression of morbidity similar to what has been reported in other cohorts with exceptional longevity. DESIGN:Case-control study. SETTING:Longevity Genes Project (LGP) and New England Centenarian Study (NECS). PARTICIPANT...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14222
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVES:To estimate the prevalence of self-harm, suicidal ideation (SI), and suicide attempts (SA) in older adults in the emergency department (ED), including differences according to age, sex, and race and ethnicity. DESIGN:Quasi-experimental, multiphase, eight-center study with prospective review of consecutive c...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.14529
更新日期:2016-10-01 00:00:00
abstract::Understanding variability in conceptions of dementia in multiethnic populations is important to improve care and guide research. The objectives of this study were to describe caregiver conceptions of dementia using a previously developed typology and to examine the correlates of conceptions of dementia in a multiethni...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53409.x
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVES:To identify factors associated with functional change in an older population and investigate interactions among selected potential risk factors. DESIGN:A population-based prospective cohort study. SETTING:A random sample was selected from the Group Health Cooperative members in the Seattle area from 1994 t...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1532-5415.2002.50408.x
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:Impact assessment of drug benefits policies is a growing field of research that is increasingly relevant to health care planning for older people. Some cost-containment policies are thought to increase noncompliance. This paper examines mechanisms that can produce spurious reductions in drug utilization meas...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50120.x
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVES:To determine the relationship between frailty and overall and cardiovascular mortality. DESIGN:Longitudinal mortality analysis. SETTING:National Health and Nutrition Examination Survey (NHANES) 1999-2004. PARTICIPANTS:Community-dwelling older adults aged 60 and older (N = 4,984; mean age 71.1 ± 0.19, 56% ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15220
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:To test the effects of a modified Hospital Elder Life Program (mHELP) on frailty. DESIGN:Matched and unmatched analyses of data from a before-and-after study. SETTING:Hospital, inpatient. PARTICIPANTS:Participants aged 65 and older (n = 189) undergoing major elective abdominal surgery at a medical center ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12651
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVES:To determine how do-not-hospitalize (DNH) orders are interpreted and used in nursing homes (NHs) once they are in place. DESIGN:Qualitative study using in-depth semi-structured interviews performed from December 2013 to April 2014. SETTING:Eight skilled nursing facilities in Connecticut that ranked in the ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14879
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:To determine the trajectory of handgrip strength (HGS) from age 70 to 90 and its association with mood, cognition, functional status, and mortality. DESIGN:Prospective follow-up of an age-homogenous representative community-dwelling cohort (born 1920-21) in the Jerusalem Longitudinal Cohort Study (1990-2015...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14509
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To identify presenting characteristics of older patients with subdural hematoma who are unlikely to survive hospitalization. DESIGN:A retrospective cohort. PATIENTS:All patients > or = 65 years of age hospitalized at a tertiary care center from 1985-1990 with the primary diagnosis of subdural hematoma. MEA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb07329.x
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:To study the effectiveness of rehabilitative and medically oriented day hospital care on community-based long-term care patients. DESIGN:A randomized, controlled trial. SETTING AND PARTICIPANTS:177 patients on home-care in a rural area were randomized into two groups. Patients in one group were offered a 2-...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1998.tb06645.x
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of influenza vaccine, rapid influenza testing, and influenza antiviral medication in nursing homes in the US to prevent and control outbreaks. METHODS:Survey questionnaires were sent to 1017 randomly selected nursing homes in nine states. Information was collected on influenza prevention,...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb02606.x
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:To identify variables associated with diagnosing dementia in poor older adults by comparing older people with dementia who were diagnosed by their primary care physicians (PCPs) with those not diagnosed by their PCP. DESIGN:Observational study. SETTING:Community-based, in-home cognitive assessment program....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01417.x
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVES:To report use of breast cancer treatment (surgery, radiation, and chemotherapy) by patients with Alzheimer's disease (AD). DESIGN:Retrospective cohort study. SETTING:Surveillance, Epidemiology, and End Results (SEER) is a population-based cancer registry covering 14% of the U.S. population. PARTICIPANTS:F...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.00467.x
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the relationship between serum insulin-like growth factor 1 (IGF-1), IGF-1 binding protein 1 (IGFBP-1), and IGF-1 binding protein 2 (IGFBP-2) and fasting insulin, fasting glucose, adiposity, and mortality in older adults. DESIGN:A prospective cohort study with mean follow-up of 6.2 years. SETTIN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02318.x
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to test whether an intervention combining increased daytime physical activity with improvement in the nighttime environment improves sleep and decreases agitation in nursing home residents. DESIGN:A randomized trial. SETTING:One community nursing home in the Los Angeles, Calif...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1999.tb03833.x
更新日期:1999-07-01 00:00:00