Assessing Risks and Benefits of Invasive Cardiac Procedures in Patients with Advanced Multimorbidity

Clin Geriatr Med. 2016 May;32(2):359-71. doi: 10.1016/j.cger.2016.01.004. Epub 2016 Feb 12.

Abstract

Age-related cardiovascular disease in older adults is more likely to occur in combination with other age-related diseases, with mounting interactive complexity as multiple morbidities accumulate. Although invasive cardiac procedures are frequently recommended for cardiovascular disease, their value is less certain in the context of age-related intricacies of care. Tools for risk assessment before invasive procedures are insensitive to risks corresponding to the unique challenges of older adults. Recognizing multimorbidity and other age-related risks provides opportunities to intervene and moderate dangers. By refocusing risk assessment in terms of patient-centered goals, the fundamental utility of invasive cardiac procedures may be reconsidered and alternative therapies prioritized.

Keywords: Cardiology; Geriatrics; Multimorbidity; Preoperative assessment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Cardiac Surgical Procedures / methods*
  • Clinical Decision-Making
  • Comorbidity
  • Humans
  • Male
  • Multiple Chronic Conditions* / epidemiology
  • Multiple Chronic Conditions* / therapy
  • Patient-Centered Care
  • Preoperative Care*
  • Risk Adjustment*
  • Risk Assessment*