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Reporting on reports--cardiological intervention in elderly patients

P J Lawson-Matthew1, K S Channer

  • 1Royal Hallamshire Hospital, Sheffield.

Journal of the Royal College of Physicians of London
|January 1, 1995
PubMed
Summary

Consultant opinions and procedural data show increased cardiological investigations and interventions for elderly patients. This trend in cardiac catheterisation and revascularisation procedures in older adults rose significantly between 1990 and 1993.

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Area of Science:

  • Cardiology
  • Geriatrics
  • Healthcare Policy

Background:

  • Attitudes towards cardiac care for the elderly have evolved.
  • Assessing changes in cardiological investigation referral patterns is crucial for geriatric cardiology.
  • Understanding trends in invasive cardiac procedures for older populations informs clinical practice.

Purpose of the Study:

  • To evaluate changes in consultant cardiologists' and geriatricians' attitudes towards investigating elderly cardiac patients over five years.
  • To determine if observed attitudinal shifts correlate with actual procedural rates in cardiothoracic centers.
  • To analyze the impact of the College report on cardiological intervention in the elderly.

Main Methods:

  • Survey of consultant cardiologists and geriatricians in the Trent Region regarding attitudes towards elderly cardiac care.

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  • Retrospective review of data from three cardiothoracic centers.
  • Analysis of trends in cardiac catheterisation and revascularisation procedures in elderly patients (1990-1993).

    • Main Results:

    • Consultant feedback indicated an increase in referrals and investigations for elderly cardiac patients.
    • Data revealed a disproportionate rise in cardiac catheterisations and revascularisation procedures among the elderly between 1990 and 1993.
    • The observed increase in interventions did not appear strongly linked to the College report's recommendations.

    Conclusions:

    • The study confirms a trend towards increased cardiological investigations and invasive procedures in elderly patients.
    • Shifting consultant attitudes appear to be a significant driver of these changes.
    • The findings suggest that clinical practice changes may precede or occur independently of formal policy recommendations.