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[Coagulation management in geriatric surgery].

H Eichler1

  • 1Institut für Klinische Hämostaseologie und Transfusionsmedizin, Universität und Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland. hermann.eichler@uks.eu.

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|November 5, 2016
PubMed
Summary
This summary is machine-generated.

Elderly patients on anticoagulation require careful surgical planning due to increased bleeding and clotting risks. Pre-operative assessment of coagulation status is crucial to manage these risks effectively.

Keywords:
AnticoagulationCoagulation disordersElderlyHemophiliaThrombophilia

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Area of Science:

  • Geriatric Medicine
  • Hematology
  • Cardiovascular Medicine

Background:

  • Elderly patients frequently have cardiovascular diseases and are often prescribed anticoagulation therapy.
  • Anticoagulation necessitates careful consideration during the planning of elective surgeries in this demographic.

Purpose of the Study:

  • To describe the etiology, diagnostic work-up, and clinical management of inherited and acquired hemophilic and thrombophilic coagulation disorders.
  • To highlight the unique challenges in managing coagulation disorders in elderly patients undergoing surgery.

Main Methods:

  • Review of clinical studies, current guidelines, and expert opinions.
  • Discussion of diagnostic approaches and management strategies for coagulation disorders.

Main Results:

  • Elderly patients exhibit acquired bleeding tendencies from medications (analgesics, cardiovascular drugs) and rarely develop acquired hemophilia.
  • These patients have a higher risk of venous and arterial thrombotic events.
  • Pre-operative exclusion of bleeding tendency via history, examination, and lab screening (e.g., prolonged activated partial thromboplastin time) is essential.

Conclusions:

  • Early initiation and comprehensive management of anticoagulation, including the post-surgery period, are vital for elderly patients.
  • Consultation with a clinical hemostaseology specialist is recommended for at-risk patients.
  • Adherence to clinical guidelines for thrombosis prophylaxis is a valuable measure.