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[Thrombosis in geriatric patients].

M Stanke¹, H T Hildebrand

¹Fachklinik für Geriatrie, Salze Klinik 1, Bad Salzdetfurth. m.stanke@uglielje.de

Deutsche Medizinische Wochenschrift (1946)

|December 18, 2001

Summary

Deep vein thrombosis (DVT) is challenging to diagnose in the elderly. A combination of factors, including prior hospitalization and female sex, increased DVT risk in this population.

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Area of Science:

Geriatric Medicine
Vascular Medicine
Diagnostic Imaging

Background:

Limited data exists on deep vein thrombosis (DVT) incidence and risk factors in the elderly population.
Classical DVT symptoms are often absent or atypical in older adults, complicating diagnosis.
Isolated leg swelling is common postoperatively or after cerebrovascular accidents, further obscuring DVT suspicion.

Purpose of the Study:

To systematically investigate patient characteristics and circumstances associated with DVT risk in geriatric patients.
To identify reliable indicators for DVT screening and referral in elderly individuals.
To improve the diagnostic accuracy of deep vein thrombosis in a geriatric setting.

Main Methods:

Prospective study involving 147 geriatric patients (101 women, 46 men; average age 76.6 years) admitted to a specialist geriatric clinic.
All patients underwent thrombosis screening with duplex sonography of both legs within 24 hours of admission.
Data collected included laboratory tests, ECG, geriatric examinations, age, sex, hospital stay duration, diagnoses, Barthel index, and medication.

Main Results:

Deep vein thrombosis (DVT) was diagnosed in 30 out of 147 patients (20.4%), with 35 new cases identified.
Significant independent risk factors for DVT included previous long hospital stays, female sex, and a higher heart rate on admission ECG.
Age, main/additional diagnoses, Barthel index, hemoglobin, prior DVT, fracture stress, and clinical suspicion were not statistically significant risk factors.

Conclusions:

Clinical assessment alone is insufficient for confirming or excluding deep vein thrombosis (DVT) in elderly patients.
A constellation of risk factors, derived from routine medical data and prior examinations, can aid in identifying patients at risk for DVT.
This approach facilitates more rational referral for diagnostic testing in geriatric populations.

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