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Heart Lung. 2015 Sep-Oct;44(5):376-81. doi: 10.1016/j.hrtlng.2015.05.005. Epub 2015 Jul 9.

Physicians' perceptions of the Thrombolysis in Myocardial Infarction (TIMI) risk score in older adults with acute myocardial infarction.

Author information

1
Yale School of Nursing, P.O. Box 27399, West Haven, CT 06516-7399, USA. Electronic address: shelli.feder@yale.edu.
2
Yale School of Nursing, P.O. Box 27399, West Haven, CT 06516-7399, USA.
3
Yale School of Medicine, Program on Aging, 300 George Street Suite 775, New Haven, CT 06510, USA.
4
Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA.
5
Yale-New Haven Hospital, Department of Internal Medicine, 330 Cedar Street, P.O. Box 208056, New Haven, CT 06520-8056, USA.
6
Yale School of Medicine, Division of Geriatrics, 333 Cedar Street, P.O. Box 208025, New Haven, CT 06520-2085, USA.
7
Yale School of Public Health, 60 College Street, P.O. Box 208034, New Haven, CT 06520-8034, USA.
8
Yale School of Medicine, Department of General Internal Medicine, 330 Cedar Street, P.O. Box 208056, New Haven, CT 06520-8056, USA.

Abstract

OBJECTIVES:

To evaluate physician-perceived strengths and limitations of the Thrombolysis in Myocardial Infarction (TIMI) risk scores for use in older adults with acute myocardial infarction (AMI).

BACKGROUND:

The TIMI risk scores are risk stratification models developed to estimate mortality risk for patients hospitalized for AMI. However, these models were developed and validated in cohorts underrepresenting older adults (≥75 years).

METHODS:

Qualitative study using semi-structured telephone interviews and the constant comparative method for analysis.

RESULTS:

Twenty-two physicians completed interviews ranging 10-30 min (mean = 18 min). Median sample age was 37 years, with a median of 11.5 years of clinical experience. TIMI strengths included familiarity, ease of use, and validation. Limitations included a lack of risk factors relevant to older adults and model scope and influence.

CONCLUSIONS:

Physicians report that the TIMI models, while widely used in clinical practice, have limitations when applied to older adults. New risk models are needed to guide AMI treatment in this population.

KEYWORDS:

Aging; Myocardial infarction; Older adult; Risk factors; Risk stratification model

PMID:
26164651
PMCID:
PMC4567390
DOI:
10.1016/j.hrtlng.2015.05.005
[Indexed for MEDLINE]
Free PMC Article

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