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Gregory Piazza1, Ali Seddighzadeh, Samuel Z Goldhaber

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Elderly patients with deep-vein thrombosis (DVT) have more comorbidities and fewer typical symptoms, making diagnosis challenging. Prophylaxis for venous thromboembolism is underutilized in this vulnerable group.

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Area of Science:

  • Gerontology
  • Vascular Medicine
  • Epidemiology

Background:

  • Venous thromboembolism (VTE), encompassing deep-vein thrombosis (DVT) and pulmonary embolism, significantly impacts elderly patient morbidity and mortality.
  • Understanding the specific characteristics of DVT in elderly populations is crucial for improving patient outcomes.

Purpose of the Study:

  • To compare the clinical characteristics and risk factors of deep-vein thrombosis (DVT) in elderly patients (≥70 years) versus nonelderly patients.
  • To assess the prevalence of venous thromboembolism (VTE) prophylaxis in elderly DVT patients.

Main Methods:

  • A prospective registry of consecutive ultrasound-confirmed deep-vein thrombosis (DVT) patients was analyzed.
  • 1932 elderly DVT patients were compared with 2554 nonelderly DVT patients.

Main Results:

  • Elderly patients (mean age 78.9 years) had higher rates of prior hospitalization, congestive heart failure, COPD, and immobilization compared to nonelderly patients (mean age 51.8 years).
  • Elderly patients were less likely to present with typical DVT symptoms like extremity discomfort or difficulty ambulating.
  • Only 41% of elderly DVT patients received venous thromboembolism prophylaxis.

Conclusions:

  • Elderly patients with deep-vein thrombosis (DVT) are a vulnerable group with significant comorbidities.
  • The atypical presentation of DVT in the elderly poses diagnostic challenges.
  • Venous thromboembolism (VTE) prophylaxis is underutilized in elderly patients diagnosed with DVT.