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Deep-vein thrombosis in the elderly.

Abstract

Venous thromboembolism, including deep-vein thrombosis and pulmonary embolism, is a major source of morbidity and mortality among elderly patients. To improve our understanding of elderly patients with deep-vein thrombosis, we compared 1932 patients with deep-vein thrombosis aged 70 years or older with 2554 nonelderly patients in a prospective registry of consecutive ultrasound-confirmed deep-vein thrombosis patients. The mean age of elderly patients was 78.9 +/- 6.1 years compared with 51.8 +/- 12.9 years in nonelderly (P < .0001). Elderly patients were more likely to have prior recent hospitalization (49.2% vs 44.7%, P = .03), congestive heart failure (20.5% vs 9.9%, P < .0001), chronic obstructive pulmonary disease (18.2% vs 11.7%, P < .0001), and recent immobilization (50.5% vs 39.6%, P < .0001) than the nonelderly patients. Elderly patients were less likely to present with typical deep-vein thrombosis symptoms of extremity discomfort (44.4% vs 60.6%, P < .0001) and difficulty ambulating (8.4% vs 11.2%, P = .002). Only 41% of elderly patients subsequently diagnosed with deep-vein thrombosis had received any venous thromboembolism prophylaxis. In conclusion, elderly patients with deep-vein thrombosis represent a particularly vulnerable population with numerous comorbid conditions. Diagnosis can present a challenge because typical deep-vein thrombosis symptoms may be absent. Fewer than 50% of elderly patients with deep-vein thrombosis had received any venous thromboembolism prophylaxis.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, Boston, MA 02215, USA. gpiazza@partners.org

    ,

    Source

    MeSH

    Aged
    Aged, 80 and over
    Comorbidity
    Female
    Humans
    Male
    Middle Aged
    Risk Factors
    Venous Thrombosis

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    18593747

    Citation

    Piazza, Gregory, et al. "Deep-vein Thrombosis in the Elderly." Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, vol. 14, no. 4, 2008, pp. 393-8.
    Piazza G, Seddighzadeh A, Goldhaber SZ. Deep-vein thrombosis in the elderly. Clin Appl Thromb Hemost. 2008;14(4):393-8.
    Piazza, G., Seddighzadeh, A., & Goldhaber, S. Z. (2008). Deep-vein thrombosis in the elderly. Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 14(4), pp. 393-8. doi:10.1177/1076029608317942.
    Piazza G, Seddighzadeh A, Goldhaber SZ. Deep-vein Thrombosis in the Elderly. Clin Appl Thromb Hemost. 2008;14(4):393-8. PubMed PMID: 18593747.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Deep-vein thrombosis in the elderly. AU - Piazza,Gregory, AU - Seddighzadeh,Ali, AU - Goldhaber,Samuel Z, Y1 - 2008/07/01/ PY - 2008/7/3/pubmed PY - 2008/11/5/medline PY - 2008/7/3/entrez SP - 393 EP - 8 JF - Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis JO - Clin. Appl. Thromb. Hemost. VL - 14 IS - 4 N2 - Venous thromboembolism, including deep-vein thrombosis and pulmonary embolism, is a major source of morbidity and mortality among elderly patients. To improve our understanding of elderly patients with deep-vein thrombosis, we compared 1932 patients with deep-vein thrombosis aged 70 years or older with 2554 nonelderly patients in a prospective registry of consecutive ultrasound-confirmed deep-vein thrombosis patients. The mean age of elderly patients was 78.9 +/- 6.1 years compared with 51.8 +/- 12.9 years in nonelderly (P < .0001). Elderly patients were more likely to have prior recent hospitalization (49.2% vs 44.7%, P = .03), congestive heart failure (20.5% vs 9.9%, P < .0001), chronic obstructive pulmonary disease (18.2% vs 11.7%, P < .0001), and recent immobilization (50.5% vs 39.6%, P < .0001) than the nonelderly patients. Elderly patients were less likely to present with typical deep-vein thrombosis symptoms of extremity discomfort (44.4% vs 60.6%, P < .0001) and difficulty ambulating (8.4% vs 11.2%, P = .002). Only 41% of elderly patients subsequently diagnosed with deep-vein thrombosis had received any venous thromboembolism prophylaxis. In conclusion, elderly patients with deep-vein thrombosis represent a particularly vulnerable population with numerous comorbid conditions. Diagnosis can present a challenge because typical deep-vein thrombosis symptoms may be absent. Fewer than 50% of elderly patients with deep-vein thrombosis had received any venous thromboembolism prophylaxis. SN - 1076-0296 UR - https://www.unboundmedicine.com/medline/citation/18593747/Deep_vein_thrombosis_in_the_elderly_ L2 - http://journals.sagepub.com/doi/full/10.1177/1076029608317942?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -