1. Primary prevention of venous thromboembolism in elderly medical patients
- Author
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Dominique Mottier, Karine Lacut, Grégoire Le Gal, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), and Université de Brest (UBO)-Université de Brest (UBO)
- Subjects
Disease ,Review ,030204 cardiovascular system & hematology ,Global Health ,MESH: Venous Thromboembolism ,medical settings ,0302 clinical medicine ,MESH: Aged, 80 and over ,Risk Factors ,MESH: Risk Factors ,Global health ,Medicine ,030212 general & internal medicine ,MESH: Treatment Outcome ,Aged, 80 and over ,MESH: Aged ,MESH: Middle Aged ,Incidence (epidemiology) ,General Medicine ,3. Good health ,Primary Prevention ,Survival Rate ,Treatment Outcome ,prophylaxis ,medicine.medical_specialty ,MESH: Survival Rate ,venous thromboembolism ,MEDLINE ,MESH: Abscess ,MESH: Anticoagulants ,elderly patients ,MESH: Splenic Diseases ,03 medical and health sciences ,Humans ,cardiovascular diseases ,Intensive care medicine ,Survival rate ,Aged ,MESH: Humans ,business.industry ,Public health ,RC952-954.6 ,Anticoagulants ,equipment and supplies ,Clinical trial ,MESH: Morbidity ,MESH: Primary Prevention ,Geriatrics ,Physical therapy ,Life expectancy ,Geriatrics and Gerontology ,Morbidity ,business ,MESH: Female ,MESH: World Health ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Karine Lacut, Grégoire Le Gal, Dominique MottierGETBO EA 3878, CHU de Brest, Department of Internal Medicine and Chest Diseases, Hôpital Cavale Blanche, Brest, FranceAbstract: Primary prophylaxis with the use of an effective and safe intervention appears the best approach of venous thromboembolism (VTE) management in medical elderly patients, the most affected by VTE. With increasing life expectancy, prevention of VTE, particularly in elderly patients, will arise as a major public health problem. Few well designed clinical trials evaluating thromboprophylaxis in medical settings were conducted in the specific population of geriatric patients. However, among the several pharmacological treatments evaluated, low molecular weight heparins enoxaparin 40 mg daily or dalteparin 5000 IU daily appeared effective and safe in the prevention of VTE in elderly patients. Despite available data, and recommendations for VTE prevention in medical patients, thromboprophylaxis is underused or misused in practice. Heterogeneity of clinical studies, selected populations, concern about bleeding, and lack of a clear clinical benefit are some of the reasons that could explain the gap between theory and practice. In this review, after a brief report of epidemiologic data and specificities of VTE in elderly patients, the authors discuss the available results of VTE primary prevention trials for elderly medical patients, the limitations of these data, and the challenges to improve the practice and to reduce the incidence of this frequent but preventable disease.Keywords: venous thromboembolism, prophylaxis, elderly patients, medical settings, review
- Published
- 2008