Factors associated with change in walking ability in very elderly patients hospitalized tor acute myocardial infarction

摘要

Background: The aim of this substudy was to identify the predictors of a lesser ability to walk in very elderly patients with acute myocardial infarction (AMI). Methods: Data from 15 acute care hospitals in the Tokai Acute Myocardial Infarction Study (TAMIS)-II sample were used. This is a prospective study of all patients admitted to the hospitals with the diagnosis of AMI from 2001 to 2003. We abstracted the baseline and procedural characteristics including walking ability from detailed chart reviews. In this substudy, patients aged 75 and over were included. Patients were stratified into two categories: 412 patients whose ability to walk was maintained (MA group) and 30 patients whose ability to walk declined (DA group). Results: The DA patients were more likely to have a lower body mass index (BMI) score and signs of heart failure on presentation (cardiac shock, 56.7% vs 15.5%; Killip class > or = III, 73.3% vs 36.6%; pulmonary edema, 60.0% vs 27.91%). DA group patients were more likely to receive vasopressors, intra-aortic balloon pump, or mechanical ventilation. After controlling for statistically significant predictors of a declined ability to walk, DA group patients were significantly more slender than MA group patients, with an adjusted odds ratio of 0.75 (95% confidence interval, 0.62-0.91). DA group patients had a higher shock or mechanical ventilation rate than MA group patients, but not significantly.Conclusions: Our results suggest that a lower BMI value and severe heart failure are significant predictors of reduced walking ability during hospitalization among very elderly patients with AMI.