C0566: Gender Impact in Deep Vein Thrombosis in the Elderly Patients

Introduction: The aging of China's population has further deepened, and according to the results of the seventh national census, the population aged 60 years and above in China was 264.02 million, accounting for 18.70% (China.2021).The rapid growth of the elderly population has led to an increase a geriatric orthopedic morbidity. The hip fracture is one of the common orthopedic diseases, which has posed a severe threat to the elderly's life and health (Yu, 2019).Purpose: In this study, we investigated the domestic and international literature, focusing on the analysis of DVT nursing prevention programs for elderly patients after hip arthroplasty, and proposed the current nursing research progress in preventing DVT to help elderly patients actively cope with DVT, improve the quality of life in later life, and make DVT a truly preventable disease.Method: Electronic searches using scholarly databases were employed and only significant articles that met the review objective were utilized.Findings: Currently, the main treatment option for hip fracture patients in clinical practice is surgery, and how to prevent Deep Vein Thrombosis (DVT) is an important task in the postoperative care of elderly orthopedic patients (Li, 2016). Research studies have shown that all elderly patients are at a very high risk of DVT during hospitalization, but the current trend is that 50% of patients at high risk of thrombosis are still not actively and effectively prevented from developing thrombosis for various reasons.Conclusion: This disease, which has a high incidence, a high mortality rate, and is difficult to prevent, requires increased attention and necessitates exploration to derive effective nursing intervention programs and related nursing measures to prevent reduce the formation of DVT and alleviate suffering for patient (Xu, 2016).In this review, we summarized the main nursing methods for preventing deep vein thrombosis of the lower extremities after hip fracture surgery in the elderly. Elderly patients are a special group of people, both physically and psychologically in a relatively fragile state, especially after the operation, so they need to be more careful in nursing work. In addition to general physical care, the care of their psychological state is also extremely important. This article describes in detail the physiological and psychological nursing interventions for patients, which can effectively guide and help medical staff to cope with the clinical care of such patients, and enable patients to better recover from surgery and trauma, and obtain a good prognosis.

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Deep-Vein Thrombosis in the Elderly

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029608317942 ◽

2007 ◽

Vol 14 (4) ◽

pp. 393-398 ◽

Cited By ~ 26

Author(s):

Gregory Piazza ◽

Ali Seddighzadeh ◽

Samuel Z. Goldhaber

Keyword(s):

Deep Vein Thrombosis ◽

Venous Thromboembolism ◽

Elderly Patients ◽

The Elderly ◽

Chronic Obstructive ◽

Thromboembolism Prophylaxis ◽

Obstructive Pulmonary Disease ◽

Vein Thrombosis ◽

Venous Thromboembolism Prophylaxis ◽

Deep Vein

Venous thromboembolism, including deep-vein thrombosis and pulmonary embolism, is a major source of morbidity and mortality among elderly patients. To improve our understanding of elderly patients with deep-vein thrombosis, we compared 1932 patients with deep-vein thrombosis aged 70 years or older with 2554 nonelderly patients in a prospective registry of consecutive ultrasound-confirmed deep-vein thrombosis patients. The mean age of elderly patients was 78.9 ± 6.1 years compared with 51.8 ± 12.9 years in nonelderly ( P < .0001). Elderly patients were more likely to have prior recent hospitalization (49.2% vs 44.7%, P = .03), congestive heart failure (20.5% vs 9.9%, P < .0001), chronic obstructive pulmonary disease (18.2% vs 11.7%, P < .0001), and recent immobilization (50.5% vs 39.6%, P < .0001) than the nonelderly patients. Elderly patients were less likely to present with typical deep-vein thrombosis symptoms of extremity discomfort (44.4% vs 60.6%, P < .0001) and difficulty ambulating (8.4% vs 11.2%, P = .002). Only 41% of elderly patients subsequently diagnosed with deep-vein thrombosis had received any venous thromboembolism prophylaxis. In conclusion, elderly patients with deep-vein thrombosis represent a particularly vulnerable population with numerous comorbid conditions. Diagnosis can present a challenge because typical deep-vein thrombosis symptoms may be absent. Fewer than 50% of elderly patients with deep-vein thrombosis had received any venous thromboembolism prophylaxis.

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Role of low molecular weight heparin in preventing deep vein thrombosis in elderly patients with hip fracture

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2017.v3.i3i.92 ◽

2017 ◽

Vol 3 (3i) ◽

pp. 585-587

Author(s):

Shreeharsha Patil ◽

Prashant Bhavani

Keyword(s):

Molecular Weight ◽

Deep Vein Thrombosis ◽

Hip Fracture ◽

Elderly Patients ◽

Low Molecular Weight Heparin ◽

Low Molecular Weight ◽

Vein Thrombosis ◽

Deep Vein

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Outcomes of Recreational Activity-Associated Trauma in Elderly Persons on Blood-Thinning Medications

The American Surgeon ◽

10.1177/000313481708300424 ◽

2017 ◽

Vol 83 (4) ◽

pp. 371-376 ◽

Cited By ~ 2

Author(s):

Zachary M. Deboard ◽

Jonathan Grotts ◽

Lisa Ferrigno

Keyword(s):

Deep Vein Thrombosis ◽

Length Of Stay ◽

Elderly Patients ◽

Odds Ratio ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Elderly Persons ◽

Recreational Activities ◽

Vein Thrombosis ◽

Deep Vein

With increasing life expectancy, the elderly are participating in recreational activities traditionally pursued by younger persons. Elderly patients have many reasons for worse outcomes after trauma, one of which may be the rising use of anticoagulant and/or antiplatelet medications. This study aimed to determine whether preinjury use of these agents yielded worse outcomes in geriatric patients injured during high-impact recreational activities. The National Trauma Data Bank was reviewed from 2007 to 2010 for patients ≥65 years admitted to Level I or II trauma centers with ICD-9 E-codes for specific mechanisms of injury. These included motorcycles, bicycles, snowmobiles, all-terrain vehicles, equestrian, water and alpine skiing, snowboarding, and others. Patients with preinjury bleeding disorder (BD), including warfarin and clopidogrel use, were compared with controls via a coarsened exact matching analysis. BD patients (294) were compared with 3929 controls. Although increased in BD patients, no significant mortality differences were observed in unmatched or matched analyses. BD patients yielded greater hospital length of stay (5 vs 4 days, P = 0.020) with increased odds of receiving five units or more of blood (7.0% vs 2.1%, odds ratio = 4.7, P < 0.001) and of deep vein thrombosis (7.6% vs 3.8%, odds ratio = 2.1, P = 0.018). Elderly patients with BD, including warfarin or clopidogrel use, do not seem to have significantly increased mortality after injury during specified recreational activities. BD patients had greater hospital length of stay, transfusion requirements, and deep vein thrombosis rates. These findings may inform counseling for those taking such medications as to the potential for adverse outcomes.

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Evaluating anticoagulation sensitivity among elderly patients managed with an institution’s heparin protocol using initial anti-factor Xa levels

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxz304 ◽

2020 ◽

Vol 77 (Supplement_1) ◽

pp. S13-S18

Author(s):

Adley Lemke ◽

Jean Kohs ◽

Lynn Weber

Keyword(s):

Elderly Patients ◽

Retrospective Cohort ◽

Elderly Population ◽

Factor Xa ◽

The Elderly ◽

Target Level ◽

P Values ◽

Vein Thrombosis ◽

Coronary Syndrome ◽

Deep Vein

Abstract Purpose The purpose of this study was to assess an institution’s heparin protocols in elderly and nonelderly adult populations to see if a response difference was observed. Methods This was a retrospective cohort study of hospitalized adults who were prescribed unfractionated heparin due to surgery, acute coronary syndrome (ACS), or deep vein thrombosis/pulmonary embolism (DVT/PE) from February 11, 2016, through August 1, 2017. Patients were divided into nonelderly adults 18 to 69 years of age and elderly patients 70 years of age or older. The anti-factor Xa (anti-Xa) level after protocol initiation was compared to the institution’s goal range of 0.3 to 0.7 IU/mL. Outcomes of each protocol in the elderly population were compared to outcomes in their nonelderly counterparts to determine if there was a difference in heparin response. Results A total of 325 patients were included in the analysis, comprising 150 elderly and 175 nonelderly adults. Elderly patients had a higher initial anti-Xa levels than did their nonelderly adult counterparts in the ACS, DVT/PE, and surgery protocols, with P values of 0.02, <0.001, and 0.01, respectively. Only the ACS protocol demonstrated increased frequency of above-target-level anti-Xa levels in the elderly (P = 0.03). Conclusion Elderly patients had significantly higher initial anti-Xa levels than did nonelderly adult patients across all protocols. This study identifies the need to further study elderly patients’ increased heparin sensitivity to determine if a separate dosing protocol is needed.

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