A recent study by Dutch researchers highlighted the dilemma many practitioners face when treating elderly patients. Approximately 4200 patients were included in the study, which was designed to examine the risks of bleeding or thromboembolism in elderly subjects treated with anticoagulation. The risk of major hemorrhage rose from 1.5 per 100 patient-years in people younger than 60 years, to 4.2 per 100 patient-years in subjects older than 80 years. In addition, the risk of thromboembolic events more than doubled when the 2 groups were compared. This higher risk of clotting problems in the elderly often necessitates anticoagulation therapy, which then creates bleeding risk. The researchers suggested that further studies should focus on ways to lower bleeding risk in these high-risk patients.
Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.
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