Alexandra Hajduk, Lisa M. Kern, Jason R. Falvey, J Shang, Jeph Herrin, Sui Tsang, Allison Aviles, Sarwat I. Chaudhry
Current evidence regarding the benefits of early outpatient follow-up for older adults after acute myocardial infarction (AMI) is conflicting, and prior studies may have been impacted by confounding by indication by not accounting for geriatric vulnerabilities. We used data from a unique nationwide cohort of older adults hospitalized with AMI, linked to Medicare data, that captured rich data on geriatric vulnerabilities and other potentially influential covariates. We used inverse-probability of treatment-weighted analyses to evaluate associations of early outpatient follow-up with hospital-free survival and physical and health-related quality of life 180 days post-discharge. More than two-fifths of the 1539 participants had a follow-up visit within 7 days, and one quarter had a follow-up visit within 8-14 days. Geriatric vulnerabilities were not more prevalent among participants receiving early outpatient follow-up, and early outpatient follow-up was not associated with differences in hospital-free survival or risk of decline in health-related quality of life.