Advertisement
Advertisement
Advertisement

Venous thromboembolism in the elderly A community-based perspective

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: http://dx.doi.org/10.1160/TH08-04-0255
Issue: 2008: 100/5 (Nov) pp. 727-954
Pages: 780-788

Venous thromboembolism in the elderly A community-based perspective

Frederick A. Spencer1,2, Joel M. Gore2, Darleen Lessard2, Cathy Emery2, Luigi Pacifico3, George Reed2, Jerry H. Gurwitz2, Robert J. Goldberg2
1Department of Medicine, McMaster University Medical Center, Hamilton, Ontario, Canada; 2Department of Medicine, University of Massachusetts Medical School, Worcester, Massachussetts, USA; 3Department of Medicine, Fallon Community Health Care, Worcester, Ontario, Canada

Summary

While the magnitude of venous thromboembolism (VTE) increases dramatically with advancing age, relatively little is known about the contemporary management ofVTE in the elderly and the impact of age on associated short- and long-term outcomes. The objectives of this population-based study were to compare the clinical characteristics,treatment practices,and outcomes of subjects ≥65 years with VTE to those of younger patients.The medical records of residents of the Worcester (MA, USA) metropolitan area with ICD-9 codes consistent withVTE during 1999, 2001, and 2003 were independently validated and reviewed by trained data abstractors. Information about patients’ demographic and clinical characteristics, hospital management practices, and hospital and long-term outcomes was collected. There were a total of 1,897 validated events of VTE – 1,048 (55%) occurred in patients ≥65 years of age. Patients ≥65 years were less likely to have “unprovoked” VTE than younger patients. They were less likely to receive parenteral anticoagulation or warfarin as acute treatment. Rates of recurrent VTE did not differ significantly between patients 65 years of age or older compared to younger patients but the adjusted rates of major bleeding were increased approximately two-fold in older patients. In conclusion, advancing age is not a predictor of recurrent VTE but is associated with a significant increase in major bleeding episodes. Physicians treating elderly patients with VTE should continue to base their decisions on clinical characteristics previously shown to impact the risk of recurrent VTE. These decisions must be tempered by our observation that major bleeding occurs frequently in these patients.

Keywords

Elderly, venous thromboembolism, bleeding, aging

DOI

http://dx.doi.org/10.1160/TH08-04-0255

You may also be interested in...

1.

S. Schulman

Hämostaseologie 2008 28 3: 110-119

2.

Sam Schulman 1, Mats Ögren 2

Thromb Haemost 2006 96 3: 258-266

http://dx.doi.org/10.1160/TH06-05-0235

3.

K. Keller (1, 2), J. Beule (3), M. Coldewey (1, 2), W. Dippold (3), J. O. Balzer (4, 5)

Phlebologie 2014 43 2: 69-76

http://dx.doi.org/10.12687/phleb2178-2-2014



Thrombosis News

Mobile technology identifies people with unknown atrial fibrillation at high risk of stroke – article published in Thrombosis and Haemostasis

The article “Feasibility and cost effectiveness of stroke prevention through community screening...

TH 111.4

The April 2014 TH 111.4 issue of Thrombosis and Haemostasis is a Theme Issue by Guest Editor B....

TH 111.3

Women with atrial fibrillation have a much higher risk for thromboembolic stroke than men suffering...