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Phlebologie 2016; 45(04): 215-218
DOI: 10.12687/phleb2315-4-2016
Review article
Schattauer GmbH

Venous thromboembolism in the elderly

Article in several languages: English | deutsch
C. Ploenes
1   Dominikus-Krankenhaus Düsseldorf, Düsseldorf/Germany
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Publication History

Received: 08 June 2016

Accepted: 10 June 2016

Publication Date:
21 December 2017 (online)

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Summary

Old age is an independent risk factor of venous thromboembolism. Nevertheless initial symptoms are often attributed to existing cardiac or pulmonary comorbidity. Once deep thromboembolism (DTE) is in focus, the synopsis of clinical findings and anamnestic clues help to take further steps to establish or rule out the diagnosis (e.g. Wells score). Treatment consists in oral anticoagulation, either by vitamin-k-antagonists or by direct oral anticoagulants (“DOACs”). Strict compliance of patients or main caregivers is essential in both cases. Simultaneous medication of platelet-inhibitingor nonsteroidal anti-inflammatory drugs – often unknown self medication – results in a raised bleeding risk and should be avoided. If longterm anticoagulation is mandatory, a strategy of sequential dose-reduced anticoagulation can be considered, especially in the case of increased bleeding-risk. Systemic fibrinolysis of pulmonary embolism goes along with a very high bleeding risk in old age and should be performed only in case of vital circulatory depression or failure.

Keywords

Venous thromboembolism - old age - geriatric patient - oral anticoagulants
 

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