Related Experiment Videos
Venous thromboembolism in the elderly. A community-based perspective
Frederick A Spencer1, Joel M Gore, Darleen Lessard
1Department of Medicine, McMaster University - Faculty of Health Sciences, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada. fspence@mcmaster.ca
Thrombosis and Haemostasis
|November 8, 2008
Summary
Elderly patients (65+) with venous thromboembolism (VTE) have similar recurrence rates but a two-fold increased risk of major bleeding compared to younger individuals. Age increases bleeding risk, not VTE recurrence.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Hematology
Background:
- Venous thromboembolism (VTE) incidence rises with age, yet management and outcomes in the elderly remain understudied.
- Understanding age-related differences in VTE is crucial for optimizing patient care.
Purpose of the Study:
- To compare clinical characteristics, treatment, and outcomes of VTE in patients aged 65 and older versus younger patients.
- To assess the impact of advanced age on VTE recurrence and bleeding complications.
Main Methods:
- Population-based study using validated medical records from the Worcester, MA metropolitan area (1999, 2001, 2003).
- Inclusion of 1,897 validated VTE events, with 55% in patients aged 65+.
- Data collection on demographics, clinical factors, hospital management, and outcomes.
Main Results:
- Older patients (65+) were less likely to have unprovoked VTE and received less parenteral anticoagulation or warfarin.
- Recurrent VTE rates did not significantly differ between age groups.
- Adjusted rates of major bleeding were approximately doubled in patients aged 65+.
Conclusions:
- Advanced age is not a predictor of VTE recurrence but is associated with a significant increase in major bleeding.
- Physicians should consider increased bleeding risk when managing VTE in elderly patients.
- Treatment decisions for elderly VTE patients must balance recurrence risk with heightened bleeding susceptibility.
Related Concept Videos
01:30Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:30Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...