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

Shelli L. Feder, Dena Schulman-Green, Mary Geda, Kathleen Williams, John A. Dodson, Michael G. Nanna, Heather G. Allore, Terrence E. Murphy, Mary E. Tinetti, Thomas M. Gill, Sarwat I. Chaudhry

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)376-381
Number of pages6
JournalHeart and Lung: Journal of Acute and Critical Care
Volume44
Issue number5
DOIs
StatePublished - Sep 1 2015

Keywords

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

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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    Feder, S. L., Schulman-Green, D., Geda, M., Williams, K., Dodson, J. A., Nanna, M. G., Allore, H. G., Murphy, T. E., Tinetti, M. E., Gill, T. M., & Chaudhry, S. I. (2015). Physicians' perceptions of the Thrombolysis in Myocardial Infarction (TIMI) risk score in older adults with acute myocardial infarction. Heart and Lung: Journal of Acute and Critical Care, 44(5), 376-381. https://doi.org/10.1016/j.hrtlng.2015.05.005