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Authors
Spencer, Frederick A.Gurwitz, Jerry H.
Schulman, Sam
Linkins, Lori-Ann
Crowther, Mark A.
Ginsberg, Jeffrey S.
Lee, Agnes Y. Y.
Saczynski, Jane S.
Anand, Sonia
Lessard, Darleen M.
Emery, Catherine
Huang, Wei
Goldberg, Robert J.
UMass Chan Affiliations
Department of Quantitative Health SciencesMeyers Primary Care Institute
Department of Medicine
Document Type
Journal ArticlePublication Date
2014-06-01Keywords
Age FactorsAged
Aged, 80 and over
Anticoagulants
Drug Administration Schedule
Female
Follow-Up Studies
Hemorrhage
Humans
Male
Proportional Hazards Models
Prospective Studies
Recurrence
Retrospective Studies
Risk Factors
Treatment Outcome
*Venous Thromboembolism
Warfarin
Cardiology
Cardiovascular Diseases
Clinical Epidemiology
Epidemiology
Geriatrics
Metadata
Show full item recordAbstract
BACKGROUND: While the incidence of venous thromboembolism increases with age, little is known about its contemporary management or outcomes in older patients. Our goal was to compare the characteristics, treatment, and outcomes associated with venous thromboembolism, in patients aged 65-69 years, 70-74 years, 75-79 years, and 80+ years. METHODS/PARTICIPANTS: We prospectively followed 542 subjects aged >/=65 years with venous thromboembolism from January 2008 through August 2011 at 6 sites. In addition, a retrospective study of 681 additional subjects aged >/=65 years with venous thromboembolism diagnosed in 2007 and 2009 was conducted at the same 6 sites. RESULTS: With advancing age, patients were more likely to suffer provoked venous thromboembolism but less likely to present with pulmonary embolism. Patients with unprovoked, provoked, or malignancy-associated venous thromboembolism received warfarin for a median of 401 days, 203 days, and 529 days, respectively. Age >/=80 years was not associated with an increased risk of recurrent venous thromboembolism, but there was an increased risk of all-cause mortality. CONCLUSION: With advancing age, patients are more likely to suffer hospital-associated and provoked venous thromboembolism. Many elderly patients with provoked or unprovoked venous thromboembolism were treated for >3 months or >12 months, respectively. Given that advanced age was not associated with increased risk of recurrent venous thromboembolism, but elderly patients in general have a higher risk of bleeding from continued anticoagulant therapy, such practice is potentially harmful. At the same time, such an argument could be used to more vigorously offer prophylaxis in the first place.Source
Am J Med. 2014 Jun;127(6):530-7.e3. doi: 10.1016/j.amjmed.2014.02.011.Link to article on publisher's siteDOI
10.1016/j.amjmed.2014.02.011Permanent Link to this Item
http://hdl.handle.net/20.500.14038/37267PubMed ID
24561112Notes
Co-author Wei Huang is a doctoral student in the Clinical and Population Health Research Program in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.
Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.amjmed.2014.02.011