Age and Sex Differences in the Magnitude of, and Hospital Death Rates Associated With, Multiple Chronic Conditions in Older Adults Hospitalized With Acute Myocardial Infarction

Authors

Mayra Tisminetzky, Meyers Primary Care Institute, Worcester, MAFollow
Jerry Gurwitz, Meyers Primary Care Institute, Worcester, MA
Hoa Nguyen, Baylor Scott & White Health, Dallas, TX
Robert Goldberg, University of Massachusetts Medical School, Worcester, MA

Publication Date

8-10-2017

Keywords

cardiovascular disease, aging, elderly, geriatrics, chronic disease

Abstract

Background: Despite the high prevalence of accompanying multimorbidity in older patients hospitalized with acute myocardial infarction, there are limited data available describing the burden of multimorbidity in different age strata of elderly men and women. The objectives of this study were to examine age- and sex-specific differences in the frequency and impact of multimorbidity on short-term outcomes in older persons hospitalized with acute myocardial infarction.

Methods: The study population consisted of 3,973 patients hospitalized with acute myocardial infarction on a biennial basis at the 11 medical centers in Worcester, Massachusetts, between 2001 and 2011.

Results: The mean age of this population was 78 years and almost half were men. In the younger older group (65–74 years), 1 in 5 women versus 1 in 4 men presented 5 or more of the 11 chronic conditions examined. The proportion of younger older women receiving evidence-based in-hospital medications and cardiac interventions was significantly lower compared to men in the same age group. Among older old patients (> 75 years), men were more likely to be diagnosed with NSTEMI and presented with a higher prevalence of chronic conditions compared to similarly aged women. Similar proportions of men and women in the older old group received evidence-based in-hospital medications. A higher prevalence of multimorbidity was significantly associated with a greater risk of dying during the index hospitalization among younger older patients, but not in the older old groups.

Conclusion: The prevalence of multimorbidity in persons hospitalized with an acute myocardial infarction is significant and highly associated with the risk of dying in younger old men and women. Our findings highlight the importance of screening for these chronic conditions in older patients hospitalized with acute myocardial infarction.

Recommended Citation

Tisminetzky M, Gurwitz J, Nguyen H, Goldberg R. Age and sex differences in the magnitude of, and hospital death rates associated with, multiple chronic conditions in older adults hospitalized with acute myocardial infarction. J Patient Cent Res Rev. 2017;4:145-6.