Factors Related to Percutaneous Coronary Intervention among Older Patients with Heart Disease in Rural Hospitals: A Retrospective Cohort Study

Abstract

Determining whether emergency catheterization is necessary for treating heart disease in older patients in rural hospitals is important. Their transportation may be affected by ageism. This retrospective cohort study investigated the relationship between patient factors and emergency catheterization in rural hospitals in patients >65 years old who visited the emergency department and were transferred to tertiary hospitals. Factors related to emergency catheterization were analyzed using a logistic regression model. The average age of the exposure and control groups was 77.61 (standard deviation [SD], 13.76) and 74.90 (SD, 16.18) years, respectively. Men accounted for 54.8 and 67.5% of patients in the exposure and control groups, respectively. Factors related to emergency catheterization were Charlson comorbidity index ≥5 (odds ratio [OR], 0.23; 95% confidence interval [CI], 0.06–0.94) and electrocardiogram (ECG) changes (OR, 3.24; 95% CI, 1.00–10.50). In these patients, age, time from onset to transfer, and serum troponin level were not significantly related to emergency catheterization, while ECG changes correlated with the indication for emergency catheterization. Emergency catheterization patients did not confirm that ageism was present. The decision for transfer to tertiary hospitals should consider comorbidities and ECG changes and should not be influenced by age, onset, and troponin level.

Keywords

• acute coronary syndrome
• catheterization
• troponin
• comorbidity
• electrocardiogram
• rural hospital