Assessing Risks and Benefits of Invasive Cardiac Procedures in Patients with Advanced Multimorbidity.
Age-related cardiovascular disease in older adults is more likely to occur in combination with other age-related diseases, with mounting interactive complexity as multiple morbidities accumulate. Although invasive cardiac procedures are frequently recommended for cardiovascular disease, their value is less certain in the context of age-related intricacies of care. Tools for risk assessment before invasive procedures are insensitive to risks corresponding to the unique challenges of older adults. Recognizing multimorbidity and other age-related risks provides opportunities to intervene and moderate dangers. By refocusing risk assessment in terms of patient-centered goals, the fundamental utility of invasive cardiac procedures may be reconsidered and alternative therapies prioritized.
Division of Cardiology, VA Boston Healthcare System, 400 Veterans of Foreign Wars Pkwy, West Roxbury, MA 02132, USA; Division of Aging, Brigham & Women's Hospital, 1620 Tremont Street, Boston, MA 02120, USA.
Ariela R
AR
Orkaby
Section of Geriatric Cardiology, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Suite 500, Pittsburgh, PA 15213, USA; Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, University Dr C, Pittsburgh, PA 15240, USA. Electronic address: formand@pitt.edu.
Daniel E
DE
Forman
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods*; D000066491:Clinical Decision-Making; D015897:Comorbidity; D006801:Humans; D008297:Male; D000071069:Multiple Chronic Conditions / Q000453:epidemiology / Q000628:therapy; D018802:Patient-Centered Care; D011300:Preoperative Care; D020379:Risk Adjustment; D018570:Risk Assessment
Cardiology; Geriatrics; Multimorbidity; Preoperative assessment