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[Anticoagulation in older patients].

Heinrich Burkhardt1

  • 1IV. Medizinische Klinik - Geriatrie, Universitätsmedizin Mannheim, Mannheim.

Deutsche Medizinische Wochenschrift (1946)
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Summary
This summary is machine-generated.

Oral anticoagulation is beneficial for older adults but requires careful monitoring of renal function and bleeding risk. Comprehensive geriatric assessment is key for managing risks and optimizing treatment in elderly patients.

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Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Cardiology

Context:

  • Oral anticoagulation is frequently prescribed for stroke prophylaxis in older patients.
  • Elderly individuals often have impaired renal function and increased bleeding risks, complicating anticoagulation therapy.

Purpose:

  • To highlight the specific risks and considerations for prescribing oral anticoagulation in older adults.
  • To emphasize the importance of renal function monitoring, bleeding risk assessment, and comprehensive geriatric evaluation.

Summary:

  • Renal function impairment necessitates dose adjustments and close monitoring in older patients on oral anticoagulation.
  • Increased bleeding risk in the elderly reduces the utility of standard scoring systems, requiring individualized assessment.
  • Adequate blood pressure control and fall risk assessment are crucial to mitigate serious adverse events like intracerebral hemorrhage and falls.
  • Comprehensive geriatric assessment aids in identifying adherence issues and discussing deprescribing options.

Impact:

  • Optimizing anticoagulation in older adults can improve stroke prevention while minimizing risks.
  • This approach supports safer and more effective long-term management of anticoagulation in the geriatric population.
  • Facilitates informed decision-making regarding anticoagulation therapy and deprescribing in elderly patients.