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.
Brotman
Daniel J
DJ
Hospitalist Program, The Johns Hopkins Hospital, Park 307, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Jaffer
Amir K
AK
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D001384:Azetidines / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D001596:Benzylamines / Q000627:therapeutic use; D000069604:Dabigatran; D017558:Elective Surgical Procedures; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D000077425:Fondaparinux; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D011134:Polysaccharides / Q000627:therapeutic use; D011355:Prodrugs / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D012307:Risk Factors; D016306:Vena Cava Filters; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D001384:Azetidines; D001562:Benzimidazoles; D001596:Benzylamines; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D011134:Polysaccharides; D011355:Prodrugs; D011725:Pyridines; C426686:ximelagatran; D000069604:Dabigatran; D000077425:Fondaparinux