Age- and sex-related utilisation of cardiac procedures and interventions: a multicentric study in Italy.
BACKGROUND
Cardiovascular diseases represent the leading cause of death in Italy and one of the most frequent cause of disability in the elderly. The aim of the study was to investigate the influence of age and sex of patient on the utilisation of cardiac procedure and interventions in Italy.


METHODS
Retrospective analysis of 2805 patients' medical case notes in cardiology, internal medicine and elderly clinics in six Italian Regions during the period 1996-1997, considering coronary catheterisation (CC), percutaneous transluminal coronary angioplasty (PCTA), coronary artery bypass grafting (CABG), thrombolysis (THR) and permanent pacemaker (PPM) implantation.


RESULTS
Older patients (more than 75 years old) were less likely to undergo CC (OR=0.062). Trends for age and sex did not achieve significance for CAGB (OR=0.815 for older patient). Age is a strong predictor of receiving PTCA, with the oldest group of patients being discriminated (OR=0.093 for people older than 75 years), and the same trend was observed for THR (OR=0.264 for patients older than 75 years). For PPM, older patient has a higher likelihood of receiving this type of intervention (OR=3.45 for 65-74 years, and OR=7.77 for patients older than 75 years). As far as gender of patients is concerned, statistically significant differences for all cardiac procedures or interventions considered were not found.


CONCLUSIONS
Clinical management of older patients with cardiac disease in Italy may be different from that of younger patients. One possible explanation would be that these patients are being discriminated against mainly because of their age.
Boccia
Antonio
A
University of Rome La Sapienza, Rome, Italy.
Damiani
Gianfranco
G
D'Errico
Marcello Maria
MM
Farinaro
Edoardo
E
Gregorio
Pasquale
P
Nante
Nicola
N
Santè
Pasquale
P
Siliquini
Roberta
R
Ricciardi
Gualtiero
G
La Torre
Giuseppe
G
Villari
Paolo
P
Boccia
Stefania
S
Sirianni
Luigi
L
Stranges
Saverio
S
Simioli
Paola
P
Garramone
Lucia
L
Gregario
Rosario
R
Minniti
Davide
D
D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D006328:Cardiac Catheterization / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D005260:Female; D006331:Heart Diseases / Q000628:therapy*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*