[Venous thromboembolic disease in a geriatric environment. Importance of its detection and treatment]

The elderly population is particularly exposed to risk of venous thromboembolism because the risk of thrombosis increases with age but also because of the side effects of anticoagulant therapy. Clinical signs are neither sensitive nor specific and systematic screen for deep vein thrombosis in elderly patients could be justified using noninvasive techniques such as echo-Doppler or assay of D-Dimers. The aim of this study was to determine the prevalence of venous thrombosis diagnosed by echo-Doppler screening in a population of institutionalized elderly subjects. The frequency of risk factors and the cost of screening and subsequent health care were also evaluated. This study included 96 patients who underwent systematic echo-Doppler measurements. Clinical, biological and echographic data were recorded on individual file-cards for analysis. The prevalence of deep vein thrombosis diagnosis was 13.5% (13/96). All the deep vein thromboses discovered were in the popliteal area. No high risk group was found and there was found and there was no significant link with clinical signs or the level of D-Dimers. The cost of diagnosis and treatment in the particular conditions of our study were 5000 and 10,700 FRF respectively for each deep vein thrombosis diagnosed. The cost of diagnostic screening and treatment should be considered in light of the life expectancy and quality of life in this population. Thus in elderly institutionalized subjects, it would appear not to be reasonable to undertake systematic screening for venous thrombosis using echo-Doppler or D-Dimer assay.