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Mortality Trends Associated With Acute Myocardial Infarction and Psychoactive Substance Use in Older Adults: A US Nationwide Analysis (1999-2020).
No full textThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2025 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.Background: Acute myocardial infarction (AMI) remains a leading cause of mortality in the USA, particularly among individuals aged 65 and older. There is limited research about the association between psychoactive substance use and cardiovascular death due to AMI. This study aims to analyze trends in AMI-related mortality among older adults (aged ≥ 65) associated with psychoactive substance use in the USA from 1999 to 2020, with a focus on demographic and geographic variations.
Methods: We conducted a descriptive analysis using death certificates from the CDC's WONDER database. Data were extracted for age, sex, race/ethnicity, urban-rural status, and geographic region. Crude mortality rates and AAMR were calculated, and temporal trends were assessed using Joinpoint regression.
Results: Between 1999 and 2020, there were 231 359 AMI-related deaths among older adults with substance use disorders. Men (39.2) had a markedly higher mortality rate than women (15.0). Mortality rates increased across all age groups, with the most pronounced rise in those aged 85 and older (33.9). Metropolitan areas (22.3) experienced lower mortality rates than nonmetropolitan areas (37.9). The Midwest (32.3) consistently recorded the highest mortality rates, followed by the Northeast (25.0), South (24.5), and West (18.7).
Conclusion: The study reveals notable temporal trends in AMI mortality among older adults with psychoactive substance use, highlighting significant demographic and regional disparities. These findings underscore the need for targeted interventions to address this growing public health issue
Evidence of emotional freedom therapy on pain management (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
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Protected therapeutic time in mental health inpatient wards (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
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Advanced epithelial ovarian cancer in older patients.
No full text© 2025 The Author(s). Published by Elsevier Inc. on behalf of European Society of Gynaecological Oncology and the International Gynecologic Cancer Society.
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)Objective: We aimed to analyze management and survival outcomes of older patients (≥75 years) with stage ≥II epithelial ovarian cancer across gynecological cancer centers in the United Kingdom.
Methods: Retrospective cohort study performed using the IMPRESS project data set. Clinical information for patients diagnosed with epithelial ovarian cancer from 6 sites of varying size and population demographics was collated between January 2018 and December 2019. We compared treatment of patients aged ≥75 years with those <75, within and between centers, using multivariate analysis to understand effects on outcomes.
Results: After exclusions, we assessed 721 patients for overall survival and 702 for progression-free survival. Patients aged ≥75 years had poorer performance status and more comorbidities. Older patients were less likely to receive combination treatment with surgery and chemotherapy (in either order) (overall = 392/721 (54.4%); <75 cohort = 320/495 (64.6%); ≥75 cohort = 72/226 (31.9%), p < .0001). Treatment varied between sites, with some having no active treatment rates of 49% for patients aged ≥75 years. Older patients had twice the relative risk of death (relative risk 1.98, 95% CI 1.63 to 2.39, p < .001). Adjustment for confounders individually caused only a relatively modest reduction in magnitude and strength of association. Adjustment for treatment led to this association essentially disappearing (relative risk 1.10, 95% CI 0.88 to 1.38, 99% reduction in χ2), though with significant variation in association between age and overall survival between treatment groups (p-heterogeneity = .0004).
Conclusions: Older women may do as well as younger women in terms of survival if treated similarly, although this varies depending on treatment groups. Treatments varied between and within sites, with some sites treating older women differently than others
Long Covid bulletin September 2025 (current awareness bulletin)
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ADHD medications and drug interactions with illicit substances (evidence summary)
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Consultant of the Week (evidence summary)
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Machine learning, statistical models and deep learning for A&E admissions (evidence summary)
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The service evaluation that failed to answer one question and threw up several others
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Development of a CMHS wellbeing strategy (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created