Prevention of venous thromboembolism in the geriatric patient.
Elderly patients immobilized because of an acute medical illness or surgery have a very high risk of developing venous thromboembolism (VTE). Aggressive pharmacologic prophylaxis is necessary and should be initiated either at admission for a medical condition or shortly after surgery. Aggressive prophylaxis may result in fewer patients developing VTE in the hospital and ultimately lead to fewer patients requiring full-dose anticoagulation for VTE. Mechanical prophylaxis can be used as an adjunct to an anticoagulant-based regimen but should only be used as primary prophylaxis when there is a contraindication, such as active bleeding. It is recommended that the clinician carefully evaluate the elderly patient's creatinine clearance and weight before prescribing anticoagulants, particularly when using fixed dosing regimens.
Jaffer
Amir K
AK
The Internal Medicine Preoperative Assessment Consultation and Treatment Center, Anticoagulation Clinic, The Cleveland Clinic Foundation, OH 44195, USA. jaffera@ccf.org
Brotman
Daniel J
DJ
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D011300:Preoperative Care / Q000379:methods; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D013923:Thromboembolism / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*
D000925:Anticoagulants