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[Coagulation/fibrinolysis disorders in the elderly]

A Deguchi1, H Wada, H Shiku

  • 1Oyamada Memorial Spa Hospital, Yokkaichi.

Rinsho Byori. the Japanese Journal of Clinical Pathology
|May 11, 2000
PubMed

Insights

Establishing new reference intervals for hemostatic tests in the elderly is crucial. Current intervals, based on young adults, do not accurately reflect coagulation and fibrinolysis in older individuals.

Area of Science:

  • Gerontology
  • Hematology
  • Clinical Chemistry

Background:

  • Hemostatic test interpretation in the elderly is challenging due to age-related physiological changes.
  • Existing reference intervals are typically derived from younger, healthy populations, potentially leading to misdiagnosis in older adults.

Purpose of the Study:

  • To establish age-specific reference intervals for hemostatic tests in elderly individuals.
  • To investigate age-related differences in coagulation and fibrinolysis markers in the elderly.
  • To assess the suitability of proposed elderly reference intervals for diagnosing disseminated intravascular coagulation.

Main Methods:

  • 11 hemostatic tests were performed on 120 elderly individuals (average age 78.6 years).
  • Participants were community-dwelling, ambulatory, and independent in daily living.
  • Statistical analyses included Wilcoxon tests and correlation coefficients to compare age groups and age with test values.

Main Results:

  • Most hemostatic test results (25.8%–93.3%) deviated from young adult reference intervals.
  • Fibrinolysis appeared more activated than coagulation in the elderly cohort.
  • Separate reference intervals are recommended for early elderly (65–74 years) and late elderly (≥75 years) for antithrombin III, protein C, D-dimer, and thrombomodulin.

Conclusions:

  • Standard reference intervals for hemostatic tests are inadequate for the elderly population.
  • Age-specific reference intervals are necessary for accurate interpretation of hemostatic function in older adults.
  • The proposed reference intervals support the diagnosis of disseminated intravascular coagulation in the elderly.

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