title: Quality of life of elderly patients after prehospital thrombolytic therapy.
abstract: We studied the long-term outcome and quality of life of elderly patients after prehospital thrombolysis to treat acute ST-elevation myocardial infarction. Data of 218 patients after prehospital thrombolytic therapy given by two physician staffed Helicopter Emergency Medical Service (HEMS) units were collected prospectively. Physical and mental status was evaluated at 4--6 months after discharge, and 1-year mortality was determined. Patients older than 65 years were compared with those younger than 65 years. There were 112 elderly and 106 younger patients. The elderly patients had more previous coronary events and more medications. Pain to therapy times between the two groups were equal (<65 years: 108+/-93 min (range 27--500 min) versus >65 years: 108+/-70 min (20-357 min)). After 4--6 months, the Barthel Daily Living Index or the Beck Depression Inventory (BDI) (depression, if BDI >/=10) showed no differences between the two groups (<65 years: 99+/-5 (range 65--100) versus >65 years: 98+/-12 (10--100); BDI>/=10, 18% versus 9%). One-year survival was lower among the elderly (79% versus 93%; p=0.001). No differences in the frequency of arrhythmias, haemodynamic problems during thrombolysis or complications such as intracranial haemorrhage after thrombolysis were detected. We concluded that elderly patients treated with prehospital thrombolysis for acute ST-elevation myocardial infarction recover mentally and physically as well as younger patients.
authors.affiliation: Arcada Polytechnic, Helsinki, Jan-Magnus Janssonin aukio 1, 00550 Helsinki, Finland. olli.vaisanen@arcada.fi
authors.forename: Olli
authors.initials: O
authors.lastname: Väisänen
authors.forename: Markku
authors.initials: M
authors.lastname: Mäkijärvi
authors.forename: Tom
authors.initials: T
authors.lastname: Silfvast
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000379:methods*; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D011336:Probability; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013300:Streptokinase / Q000627:therapeutic use; D015996:Survival Rate; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase; D010959:Tissue Plasminogen Activator