Ability to Stand and Walk Helps Identify High-Risk Elderly Adults After Heart Attack

Jun 03, 2019

Experts develop a risk model to identify which elderly adults are likely to experience complications after a heart attack.

A new risk model helps identify which elderly adults are likely to experience complications after a heart attack, based on findings published in Circulation: Cardiovascular Quality and Outcomes. The model found general mobility is the strongest predictor of risk and could be used to improve outcomes in elderly heart attack survivors.

Using data from SILVER-AMI (Comprehensive Evaluation of Risk in Older Adults with AMI), this study explored factors that impact risk of complications after heart attack. It looked at 72 factors that can impact outcomes, such as blood pressure, strength, fall risk and cognitive status. The most important factors were then used to develop a model that predicts risk of hospital readmission.

According to experts, such a tool could help high-risk patients get better monitoring and treatment, potentially improving survival. However, current tools are lacking, especially in older and elderly adults.

The study included more than 3,000 elderly adults treated for heart attack at 94 U.S. hospitals. Upon enrollment, participants completed interviews, surveys and medical exams to assess their health as well as physical and cognitive function. They were then followed for 30 days for key outcomes such as readmission to the hospital.

In total, 18% of participants were readmitted to the hospital for various complications in the month after their heart attack. Authors note that these patients were more likely to be older, have chronic diseases and have more physical impairments than those without complications.

Among all risk factors researchers looked at, eight of the strongest variables were used in the prediction model, including factors such as blood pressure, health status, mobility and the use of blood thinners.

Among those, authors found that functional mobility was the strongest predictor of readmission risk. Functional mobility was defined as a patient’s ability to get up from a chair and walk ten feet, which is a good indicator of their ability to complete everyday activities.

Authors note that their model worked fairly well at identifying study participants who were readmitted for complications. However, factors like mobility and blood pressure didn’t explain all of differences in rehospitalizations.

Experts hope that with additional research, we can continue to learn about factors that impact outcomes after heart attack and improve long-term survival among elderly patients.

• How can I help prevent a second heart attack?
• Patients with a history of heart attack have significantly increased risk of a second heart event. Participating in a cardiac rehabilitation program can help patients regain strength after a heart attack and teach individuals how to prevent a second heart attack, like by quitting smoking, reducing blood pressure, staying active, eating healthy, and adhering to therapies advised by the doctor.