{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:03:26Z","timestamp":1767175406496,"version":"build-2238731810"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2008,6,28]],"date-time":"2008-06-28T00:00:00Z","timestamp":1214611200000},"content-version":"vor","delay-in-days":485,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Elder patients with acute coronary syndromes (ACS) are less likely to receive cardiac catheterization. The reasons for this are unclear.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Objectives:<\/jats:bold>\n                    To assess whether elder patients who had a documented history of dementia, lived in extended care facilities, or had do not intubate\u2013do not resuscitate (DNR\u2010DNI) advance directives were less likely to receive cardiac catheterization, despite having ACS with high\u2010risk features.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    This was a medical record review conducted at an urban teaching hospital. DNR\u2010DNI status before hospitalization, extended care facility (nursing home or assisted living) residence, and a previous diagnosis of dementia were obtained from the medical record. Patients 65 years and older who presented to the emergency department with acute myocardial infarction or with unstable angina with ST segment deviation were included. Univariate and multivariate logistic regression were performed, and odds ratios (ORs) were reported with their 95% confidence intervals (CIs).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Of the 201 eligible patients, 66 (32.8%) patients did not undergo cardiac catheterization. In the univariate analysis, patients who had dementia, resided in extended care facilities, or were DNR\u2010DNI were less likely to receive cardiac catheterization. Only extended care facility residence (OR, 0.18; 95% CI = 0.04 to 0.83) and DNR\u2010DNI status (OR, 0.19; 95% CI = 0.04 to 0.92) remained significantly associated with decreased cardiac catheterization in the multivariate analysis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Elder patients with ACS residing in extended care facilities or who are DNR\u2010DNI are less likely to receive cardiac catheterization. Future studies concerning the quality of ACS care for elders should take these variables into account.\n                  <\/jats:p>","DOI":"10.1197\/j.aem.2006.09.054","type":"journal-article","created":{"date-parts":[[2007,1,22]],"date-time":"2007-01-22T20:58:52Z","timestamp":1169499532000},"page":"228-233","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Factors Affecting Cardiac Catheterization Rates in Elders with Acute Coronary Syndromes"],"prefix":"10.1111","volume":"14","author":[{"given":"Jin H.","family":"Han","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen F.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan 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