title: [Oral anticoagulation and risk of bleeding in elderly patients - the aspect of polypharmacy].
abstract: Oral anticoagulant therapy has been shown to be of benefit also in elderly patients in various therapeutic and prophylactic indications. Despite strong evidence in literature, doctors still refuse to prescribe oral anticoagulants to geriatric patients in daily routine. Main reason for this decision is the fear of secondary bleeding complications. According to clinical trial data, distinct risk factors for bleeding attributed to anticoagulant treatment may be determined: age >70 years, female gender, recurrent bleeding events, alcohol/drug abuse, diabetes, anaemia and polypharmacy. The entire article reveals the literature in Medline and Cochrane Library from 1980 to 2009 including the hits "polypharmacy - anticoagulant treatment - elderly patients". It further highlights risk assessment strategies in elderly patients, and possible pharmacokinetic and -dynamic interactions of drugs co-administered with oral anticoagulants.
authors.affiliation: Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Austria. regina.roller-wirnsberger@meduni-graz.at.
authors.forename: Regina E
authors.initials: RE
authors.lastname: Roller
authors.affiliation: Universitätsklinik für Geriatrie, Paracelsus Medizinische Privatuniversität, Salzburg, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Iglseder
authors.affiliation: Abteilung für Akutgeriatrie/Remobilisation, Landeskrankenhaus Gmunden, Gmunden, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Dovjak
authors.affiliation: Abteilung für Innere Medizin und Akutgeriatrie, Landeskrankenhaus Hochzirl, Zirl, Austria.
authors.forename: Monika
authors.initials: M
authors.lastname: Lechleitner
authors.affiliation: Abteilung für Akutgeriatrie, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Wien, Austria.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Sommeregger
authors.affiliation: Abteilung für Innere Medizin und Akutgeriatrie, Landeskrankenhaus Hochzirl, Zirl, Austria.
authors.forename: Ursula
authors.initials: U
authors.lastname: Benvenuti-Falger
authors.affiliation: Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Austria.
authors.forename: Ronald
authors.initials: R
authors.lastname: Otto
authors.affiliation: Abteilung für Akutgeriatrie, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Wien, Austria.
authors.forename: Birgit
authors.initials: B
authors.lastname: Böhmdorfer
authors.affiliation: Abteilung für Innere Medizin und Akutgeriatrie, Landeskrankenhaus Hochzirl, Zirl, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Gosch
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D016330:Frail Elderly; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D012008:Recurrence; D012307:Risk Factors
chemical_list: D000925:Anticoagulants