Activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction

Hiroyuki Nakajima,1 Jiro Yoshioka,2 Nobuyuki Totsuka,2 Izumi Miyazawa,2 Tatsuya Usui,2 Nobuyuki Urasawa,2 Takahiro Kobayashi,3 Tomoaki Mochidome4 1Department of Cardiology, Nagano Matsushiro General Hospital, 2Department of Cardiology, Nagano Red Cross Hospital, 3Department of Cardiology, Nagano Mu...

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Autores principales:	Nakajima H, Yoshioka J, Totsuka N, Miyazawa I, Usui T, Urasawa N, Kobayashi T, Mochidome T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Acute myocardial infarction Activities of daily living Disability Killip classification Primary percutaneous coronary intervention Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/a65d3e8867c14aeb9e5cd560eebb83b0
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spelling	oai:doaj.org-article:a65d3e8867c14aeb9e5cd560eebb83b02021-12-02T06:58:38ZActivities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction1178-1998https://doaj.org/article/a65d3e8867c14aeb9e5cd560eebb83b02016-08-01T00:00:00Zhttps://www.dovepress.com/activities-of-daily-living-as-an-additional-predictor-of-complications-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Hiroyuki Nakajima,1 Jiro Yoshioka,2 Nobuyuki Totsuka,2 Izumi Miyazawa,2 Tatsuya Usui,2 Nobuyuki Urasawa,2 Takahiro Kobayashi,3 Tomoaki Mochidome4 1Department of Cardiology, Nagano Matsushiro General Hospital, 2Department of Cardiology, Nagano Red Cross Hospital, 3Department of Cardiology, Nagano Municipal Hospital, Nagano, 4Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan Background: Age is an important determinant of outcome in acute myocardial infarction (AMI). However, in clinical settings, there is an occasional mismatch between chronological age and physical age. We evaluated whether activities of daily living (ADL), which reflect physical age, also predict complications and prognosis in elderly patients with AMI.Design: Single-center, observational, and retrospective cohort study.Methods: Preserved ADL and low ADL were defined according to the scale for independence degree of daily living for the disabled elderly by the Japanese Ministry of Health, Labour, and Welfare. We examined 82 consecutive patients aged ≥75 years with AMI who underwent primary percutaneous coronary intervention. Patients were divided into preserved ADL (n=52; mean age, 81.8±4.8 years; male, 59.6%) and low ADL (n=30; mean age, 85.8±4.7 years; male, 40.0%) groups according to prehospital ADL.Results: The prevalence of Killip class II–IV and in-hospital mortality rate were significantly higher with low ADL compared to that with preserved ADL (23.1% vs 60.0%, P=0.0019; 5.8% vs 30.0%, P=0.0068, respectively). Multivariate analysis showed that ADL was an independent predictor of Killip class II–IV and 1-year mortality after adjusting for age, sex, and other possible confounders (odds ratio 5.11, 95% confidence interval [CI] 1.52–17.2, P=0.0083; hazard ratio 4.32, 95% CI 1.31–14.3, P=0.017, respectively).Conclusion: Prehospital ADL is a significant predictor of heart failure complications and prognosis in elderly patients with AMI undergoing primary percutaneous coronary intervention, irrespective of age and sex. Keywords: acute myocardial infarction, activities of daily living, disability, Killip classification, primary percutaneous coronary interventionNakajima HYoshioka JTotsuka NMiyazawa IUsui TUrasawa NKobayashi TMochidome TDove Medical PressarticleAcute myocardial infarctionActivities of daily livingDisabilityKillip classificationPrimary percutaneous coronary interventionGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 1141-1147 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Acute myocardial infarction Activities of daily living Disability Killip classification Primary percutaneous coronary intervention Geriatrics RC952-954.6
spellingShingle	Acute myocardial infarction Activities of daily living Disability Killip classification Primary percutaneous coronary intervention Geriatrics RC952-954.6 Nakajima H Yoshioka J Totsuka N Miyazawa I Usui T Urasawa N Kobayashi T Mochidome T Activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction
description	Hiroyuki Nakajima,1 Jiro Yoshioka,2 Nobuyuki Totsuka,2 Izumi Miyazawa,2 Tatsuya Usui,2 Nobuyuki Urasawa,2 Takahiro Kobayashi,3 Tomoaki Mochidome4 1Department of Cardiology, Nagano Matsushiro General Hospital, 2Department of Cardiology, Nagano Red Cross Hospital, 3Department of Cardiology, Nagano Municipal Hospital, Nagano, 4Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan Background: Age is an important determinant of outcome in acute myocardial infarction (AMI). However, in clinical settings, there is an occasional mismatch between chronological age and physical age. We evaluated whether activities of daily living (ADL), which reflect physical age, also predict complications and prognosis in elderly patients with AMI.Design: Single-center, observational, and retrospective cohort study.Methods: Preserved ADL and low ADL were defined according to the scale for independence degree of daily living for the disabled elderly by the Japanese Ministry of Health, Labour, and Welfare. We examined 82 consecutive patients aged ≥75 years with AMI who underwent primary percutaneous coronary intervention. Patients were divided into preserved ADL (n=52; mean age, 81.8±4.8 years; male, 59.6%) and low ADL (n=30; mean age, 85.8±4.7 years; male, 40.0%) groups according to prehospital ADL.Results: The prevalence of Killip class II–IV and in-hospital mortality rate were significantly higher with low ADL compared to that with preserved ADL (23.1% vs 60.0%, P=0.0019; 5.8% vs 30.0%, P=0.0068, respectively). Multivariate analysis showed that ADL was an independent predictor of Killip class II–IV and 1-year mortality after adjusting for age, sex, and other possible confounders (odds ratio 5.11, 95% confidence interval [CI] 1.52–17.2, P=0.0083; hazard ratio 4.32, 95% CI 1.31–14.3, P=0.017, respectively).Conclusion: Prehospital ADL is a significant predictor of heart failure complications and prognosis in elderly patients with AMI undergoing primary percutaneous coronary intervention, irrespective of age and sex. Keywords: acute myocardial infarction, activities of daily living, disability, Killip classification, primary percutaneous coronary intervention
format	article
author	Nakajima H Yoshioka J Totsuka N Miyazawa I Usui T Urasawa N Kobayashi T Mochidome T
author_facet	Nakajima H Yoshioka J Totsuka N Miyazawa I Usui T Urasawa N Kobayashi T Mochidome T
author_sort	Nakajima H
title	Activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction
title_short	Activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction
title_full	Activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction
title_fullStr	Activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction
title_full_unstemmed	Activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction
title_sort	activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/a65d3e8867c14aeb9e5cd560eebb83b0
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Activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction

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