Hemorrhagic Complications of Heparin Therapy in Elderly People

The most important side effect of heparin therapy is bleeding. The reported incidence has varied widely and the relationship of bleeding to dose, route of administration, age, sex, underlying haemostatic defect and hypertension has been suggested. A review of one years experience with subcutaneous heparin in 113 elderly patients is presented in this paper. They are divided into three groups : Group I without laboratory control, Group II - dosage of heparin being controlled with recalcification plasma test, and Group III-heparin requirement controlled by thrombo-elastography. Group I - 24 women (average age 82.1 years) receiving 5000 I.U. every 8 or 12 hours, mean duration of treatment 24 days ± 13.3 : one fatal retroperitoneal haemorrhage. Group II - 35 females, 10 males (average age 81.3 years), mean daily dose of heparin 13.250 I.U.(TID), duration of treatment 30.3 ± 24 days, 10 patients sustained bleeding complications. Group III -38 females, 6 males (average age 81.6 years), average daily heparin requirement 12.250 I.U. (TID), mean duration of treatment 42.2±55.5, 4 patients developed minor bleeding.

The relationship between age, sex, control of heparin dosage and existence of hypertension will be discussed in detail.