The Influence of Age on Policies for Admission and Thrombolysis in Coronary Care Units in the United Kingdom

Abstract

Age is an important factor influencing survival following an acute myocardial infarction. In clinical practice many elderly patients are neither admitted to coronary care nor receive thrombolytic therapy. A postal questionnaire was sent to all 175 consultants in charge of coronary care units in the United Kingdom to determine whether age-related policies are being operated which are limiting the access of elderly patients to life-saving interventions. One hundred and thirty-four questionnaires (77%) were returned. One-fifth of coronary care units operate an age-related admission policy, and two-fifths operate an age-related thrombolysis policy. The age limits used by many of these units are likely to exclude large numbers of patients who could benefit from cardiac monitoring and resuscitation as well as thrombolytic treatment. The abolition of age-related policies would help to ensure that thrombolysis is readily available to the group of patients most likely to benefit from it.