医生对老年急性心肌梗死患者心肌梗死溶栓（TIMI）风险评分的认知。
Physicians' perceptions of the Thrombolysis in Myocardial Infarction (TIMI) risk score in older adults with acute myocardial infarction.
作者信息
Feder Shelli L, Schulman-Green Dena, Geda Mary, Williams Kathleen, Dodson John A, Nanna Michael G, Allore Heather G, Murphy Terrence E, Tinetti Mary E, Gill Thomas M, Chaudhry Sarwat I
机构信息
Yale School of Nursing, P.O. Box 27399, West Haven, CT 06516-7399, USA.
Yale School of Nursing, P.O. Box 27399, West Haven, CT 06516-7399, USA.
出版信息
Heart Lung. 2015 Sep-Oct;44(5):376-81. doi: 10.1016/j.hrtlng.2015.05.005. Epub 2015 Jul 9.
OBJECTIVES
To evaluate physician-perceived strengths and limitations of the Thrombolysis in Myocardial Infarction (TIMI) risk scores for use in older adults with acute myocardial infarction (AMI).
BACKGROUND
The TIMI risk scores are risk stratification models developed to estimate mortality risk for patients hospitalized for AMI. However, these models were developed and validated in cohorts underrepresenting older adults (≥75 years).
METHODS
Qualitative study using semi-structured telephone interviews and the constant comparative method for analysis.
RESULTS
Twenty-two physicians completed interviews ranging 10-30 min (mean = 18 min). Median sample age was 37 years, with a median of 11.5 years of clinical experience. TIMI strengths included familiarity, ease of use, and validation. Limitations included a lack of risk factors relevant to older adults and model scope and influence.
CONCLUSIONS
Physicians report that the TIMI models, while widely used in clinical practice, have limitations when applied to older adults. New risk models are needed to guide AMI treatment in this population.
目的
评估医生对心肌梗死溶栓（TIMI）风险评分在老年急性心肌梗死（AMI）患者中应用的优势和局限性。
背景
TIMI风险评分是用于估计因AMI住院患者死亡风险的风险分层模型。然而，这些模型是在老年人群（≥75岁）代表性不足的队列中开发和验证的。
方法
采用半结构化电话访谈进行定性研究，并使用持续比较法进行分析。
结果
22名医生完成了时长为10 - 30分钟（平均 = 18分钟）的访谈。样本年龄中位数为37岁，临床经验中位数为11.5年。TIMI的优势包括熟悉度、易用性和有效性。局限性包括缺乏与老年人相关的风险因素以及模型范围和影响力。
结论
医生报告称，TIMI模型虽在临床实践中广泛使用，但应用于老年人时存在局限性。需要新的风险模型来指导该人群的AMI治疗。
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