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抗血栓薬の使用と血栓症に関連する合併症との関連
Christopher J D Wallis1,2, Tristan Juvet1, Yuna Lee3
1Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
JAMA
|October 4, 2017
まとめ
抗血栓薬は,高齢者の血流関連の合併症のリスクを大幅に増加させます. 緊急治療室への訪問,入院,大出血症の泌尿器科手術の割合が高くなります.
科学分野:
- 高齢者医療
- 薬理学について
- 泌尿器科
背景:
- 抗血栓薬は,血栓の発生を防ぐために広く処方されています.
- ヘマチュリアは潜在的な合併症であり,高齢者の関連リスクのさらなる理解が必要である.
研究 の 目的:
- 抗血栓薬の使用と高齢者の血関連合併症との関連を調査する.
- これらの合併症の発生率を,抗血栓剤の曝露に関連して定量化する.
主な方法:
- カナダのオンタリオ州で人口を基に遡及的なコホート研究が行われました.
- 2002年から2014年までの66歳以上の市民を対象に,経口抗凝固剤や抗血小板剤の投与を分析した.
- ヘマチュリアに関連する合併症は,急診,入院,または重度のヘマチュリアのための泌尿器科の手順と定義された.
主要な成果:
- この研究では2,518,064人の患者が分析され,そのうち808,897人が抗血栓剤に曝露した.
- 抗血栓剤を投与された患者は,非暴露患者 (80. 17症例/ 1000人年) と比較して,出血に関連した合併症の割合が著しく高かった (123. 95症例/ 1000人年).
- 泌尿器科の手術,入院,緊急診療での合併症率は高かった. 抗凝固剤と抗血小板剤の両方を使用した患者では,最も高いリスク (191. 61例/1000人年) が示された.
結論:
- 高齢者における抗血栓薬の使用は,出血に関連した合併症のリスクを大幅に増加させる.
- これらの発見は,抗血栓治療を処方された高齢者の血栓のモニタリングの重要性を強調しています.
- この研究は,抗血栓薬の使用と後の膀癌の診断との間の潜在的な関連を示唆しています.
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