Academic Journal
Anticoagulation Management Practices and Outcomes in Elderly Patients with Acute Venous Thromboembolism: A Clinical Research Study.
| العنوان: | Anticoagulation Management Practices and Outcomes in Elderly Patients with Acute Venous Thromboembolism: A Clinical Research Study. |
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| المؤلفون: | Insam, C., Méan, M., Limacher, A., Angelillo-Scherrer, A., Aschwanden, M., Banyai, M., Beer, J.H., Bounameaux, H., Egloff, M., Frauchiger, B., Husmann, M., Kucher, N., Lämmle, B., Matter, C., Osterwalder, J., Righini, M., Staub, D., Rodondi, N., Aujesky, D. |
| المصدر: | PloS one, vol. 11, no. 2, pp. e0148348 |
| سنة النشر: | 2016 |
| المجموعة: | Université de Lausanne (UNIL): Serval - Serveur académique lausannois |
| مصطلحات موضوعية: | Acute Disease, Aged, Anticoagulants/therapeutic use, Female, Humans, Length of Stay, Male, Medication Adherence/statistics & numerical data, Treatment Outcome, Venous Thromboembolism/drug therapy |
| الوصف: | Whether anticoagulation management practices are associated with improved outcomes in elderly patients with acute venous thromboembolism (VTE) is uncertain. Thus, we aimed to examine whether practices recommended by the American College of Chest Physicians guidelines are associated with outcomes in elderly patients with VTE. We studied 991 patients aged ≥65 years with acute VTE in a Swiss prospective multicenter cohort study and assessed the adherence to four management practices: parenteral anticoagulation ≥5 days, INR ≥2.0 for ≥24 hours before stopping parenteral anticoagulation, early start with vitamin K antagonists (VKA) ≤24 hours of VTE diagnosis, and the use of low-molecular-weight heparin (LMWH) or fondaparinux. The outcomes were all-cause mortality, VTE recurrence, and major bleeding at 6 months, and the length of hospital stay (LOS). We used Cox regression and lognormal survival models, adjusting for patient characteristics. Overall, 9% of patients died, 3% had VTE recurrence, and 7% major bleeding. Early start with VKA was associated with a lower risk of major bleeding (adjusted hazard ratio 0.37, 95% CI 0.20-0.71). Early start with VKA (adjusted time ratio [TR] 0.77, 95% CI 0.69-0.86) and use of LMWH/fondaparinux (adjusted TR 0.87, 95% CI 0.78-0.97) were associated with a shorter LOS. An INR ≥2.0 for ≥24 hours before stopping parenteral anticoagulants was associated with a longer LOS (adjusted TR 1.2, 95% CI 1.08-1.33). In elderly patients with VTE, the adherence to recommended anticoagulation management practices showed mixed results. In conclusion, only early start with VKA and use of parenteral LMWH/fondaparinux were associated with better outcomes. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/26906217; info:eu-repo/semantics/altIdentifier/eissn/1932-6203; info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_520EEF9DDA2A6; https://serval.unil.ch/notice/serval:BIB_520EEF9DDA2A; https://serval.unil.ch/resource/serval:BIB_520EEF9DDA2A.P001/REF.pdf |
| DOI: | 10.1371/journal.pone.0148348 |
| الاتاحة: | https://serval.unil.ch/notice/serval:BIB_520EEF9DDA2A https://doi.org/10.1371/journal.pone.0148348 https://serval.unil.ch/resource/serval:BIB_520EEF9DDA2A.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_520EEF9DDA2A6 |
| Rights: | info:eu-repo/semantics/openAccess ; Copying allowed only for non-profit organizations ; https://serval.unil.ch/disclaimer |
| رقم الانضمام: | edsbas.C0DE8E47 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1371/journal.pone.0148348 |
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