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COMMENTS AND OPINIONS
Is Concentration on More Intensive Treatment for Younger Patients More Rational and Humane Than Ignorant?
Michael Jelinek, MBBS, MD, FRACP, FACC, FCSANZ
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The article by Yan et al1 has shown that physicians have seriously underestimated the impact of patient age and chronic comorbidities on the prognosis of patients presenting with acute coronary syndromes (ACSs). Indeed, up to a point, the age of the patient, rather than the severity of the acute illness, is the major determinant of outcomes from ACS. I suggest that the concentration on more intensive treatment for younger patients may be more appropriate than ignorant.
From a risk management perspective, a fatal error in a 50-year-old patient with ACS would result in a loss of 26 years of life expectancy. A similar fatal error in an 80-year-old patient would result in a loss of 7 years of life expectancy. This is a loss of life expectancy of 19 years more in the younger than in the older patient. If we considered the . . . [Full Text of this Article]
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RELATED ARTICLE
Understanding Physicians' Risk Stratification of Acute Coronary Syndromes: Insights From the Canadian ACS 2 Registry
Andrew T. Yan, Raymond T. Yan, Thao Huynh, Amparo Casanova, F. Emilio Raimondo, David H. Fitchett, Anatoly Langer, Shaun G. Goodman, and for the Canadian Acute Coronary Syndrome Registry 2 Investigators
Arch Intern Med. 2009;169(4):372-378.
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RELATED LETTER
Is Concentration on More Intensive Treatment for Younger Patients More Rational and Humane Than Ignorant?—Reply
Andrew T. Yan, Raymond T. Yan, and Shaun G. Goodman
Arch Intern Med. 2009;169(15):1442-1443.
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