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Older, multimorbid patients carry a high risk of suffering from a thromboembolic disease. The incidence of deep vein thrombosis in the outpatient setting is, depending on age, between 71 and 132 cases per 100,000 inhabitants and year. The rates increase significantly in the hospital setting and with increasing age. Today, pharmacological thrombolytic prophylaxis is the gold standard in patients needing surgical and internal medical care and is described in international evidence-based guidelines. However, the percentage of patients, who despite the guidelines do not receive pharmacological thrombolytic prophylaxis, is still very high. This is especially true for the group of multimorbid, very old patients. In the present work, the pathophysiological and clinical background for the increased susceptibility of thromboembolism in geriatric patients is summarized and the drugs currently available for pharmacological thromboembolic prophylaxis are presented. Hereby, special emphasis is placed on aspects of application in the elderly.
Fachbereich Geriatrie und kompetenzbasierte Curriculumsentwicklung, Medizinische Universität Graz, Auenbruggerplatz 15, 8036, Graz, Österreich, Regina.Roller-Wirnsberger@medunigraz.at.
This article was published in the following journal.
Name: Zeitschrift fur Gerontologie und Geriatrie
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An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.
A broad-spectrum antibiotic that is being used as prophylaxis against disseminated Mycobacterium avium complex infection in HIV-positive patients.
Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures.
DEEP VEIN THROMBOSIS of an upper extremity vein (e.g., AXILLARY VEIN; SUBCLAVIAN VEIN; and JUGULAR VEINS). It is associated with mechanical factors (Upper Extremity Deep Vein Thrombosis, Primary) secondary to other anatomic factors (Upper Extremity Deep Vein Thrombosis, Secondary). Symptoms may include sudden onset of pain, warmth, redness, blueness, and swelling in the arm.
Tight coverings for the foot and leg that are worn to aid circulation in the legs and prevent the formation of EDEMA and DEEP VEIN THROMBOSIS. PNEUMATIC COMPRESSION STOCKINGS serve a similar purpose especially for bedridden patients and following surgery.