scholarly journals Outcome of Elderly Patients with Venous Thromboembolism Treated with Direct Oral Anticoagulants—A Retrospective Cohort Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5673
Author(s):  
Irit Ayalon-Dangur ◽  
Yakov Vega ◽  
Miriam Rozi Israel ◽  
Alon Grossman ◽  
Galia Spectre ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
Elderly Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Cohort Analysis ◽  
The Elderly ◽  
Composite Outcome

Introduction: Randomized controlled trials that compared direct oral anticoagulants (DOACs) to vitamin K antagonists (VKA) for the treatment of venous thromboembolism (VTE), demonstrated both efficacy and safety of DOACs. The aim of the current study was to compare DOACs to VKA for the treatment of VTE in the elderly, in a real-life setting. Methods: A retrospective cohort study was performed in Rabin Medical Center encompassing a 7-year period. Hospitalized patients >65 years, with a diagnosis of VTE discharged with DOACs or VKA were included. The primary outcome was a composite of all-cause mortality, major bleeding, recurrent VTEs and hospitalizations throughout the follow-up period of one year. Results: A total of 603 patients were included in the final analysis. The mean age was 79.6 ± 8.5 years. The primary composite outcome occurred in 74.6% and 56.7% of the patients in the VKA group and DOACs group, respectively, hazard ratio 0.59, 95% confidence interval 0.46 to 0.76, in favor of the DOACs group. In a matched cohort analysis, the results were the same as the original analysis. Conclusion: In the elderly population, treatment of VTE with DOACs was associated with a lower rate of the composite outcome. DOACs are safe and effective for elderly patients with VTE.

Management of concomitant hyperparathyroidism and thyroid diseases in the elderly patients: a retrospective cohort study

2016 ◽  
Vol 29 (S1) ◽  
pp. 29-33 ◽  
Author(s):  
Alessandra Panarese ◽  
Vito D’Andrea ◽  
Stefano Pontone ◽  
Pasqualino Favoriti ◽  
Daniele Pironi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
The Elderly ◽  
Thyroid Diseases

Direct Oral Anticoagulants Versus Warfarin for Treatment of Thrombosis or Atrial Fibrillation in Patients With Cirrhosis: A Retrospective Cohort Study

2021 ◽  
pp. 106002802110250
Author(s):  
Eric M. Coons ◽  
Britta A. Staubes ◽  
Ashley L. Casey ◽  
Stephanie A. Elagizi-Youssef ◽  
Alaa E. Mohammed ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Major Bleeding ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Small Sample ◽  
Class B ◽  
Class C

Background Evidence for direct oral anticoagulants (DOACs) in patients with cirrhosis is limited. Few patients with Child-Turcotte-Pugh (CTP) class B and C cirrhosis have been studied. Objective To compare major bleeding rates in patients with cirrhosis receiving a DOAC versus warfarin. Methods A retrospective cohort study was conducted in adults with cirrhosis receiving a DOAC versus warfarin for venous thromboembolism, portal-vein thrombosis, or atrial fibrillation. The primary outcome was the rate of major bleeding. Secondary outcomes included time to major bleeding, clinically relevant nonmajor bleeding, all bleeding, gastrointestinal bleeding, intracranial bleeding, and new thromboembolic events. The study was approved by the Ochsner Health System Institutional Review Board. Results A total of 44 patients receiving a DOAC and 41 patients receiving warfarin were included. Major bleeding occurred in 4 patients receiving a DOAC and 6 patients receiving warfarin (9.1% vs 14.6%; P = 0.881). Rates of major bleeding were similar in 24 DOAC and 17 warfarin patients with CTP Class B (4.2% vs 17.6%; P = 0.37) and 8 DOAC and 9 warfarin patients with CTP Class C (37.5% vs 11.1%; P = 0.41) cirrhosis. Secondary bleeding and efficacy outcomes were similar between cohorts. The study was limited by a small sample size. Conclusion and Relevance Treatment with DOACs in patients with cirrhosis was associated with a similar rate of major bleeding compared with warfarin. Inclusion of CTP class C patients in future studies remains valuable to evaluate safety and efficacy of DOACs in this population.

scholarly journals Potentially Inappropriate Medication Use and the Hospitalization Rate among Thai Elderly Patients: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Vorawee Varavithya ◽  
Chayanee Tirapat ◽  
Penpitcha Rojpibulstit ◽  
Panadda Poovichayasumlit ◽  
Vanida Prasert ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Inappropriate Medication ◽  
The Elderly ◽  
Hospitalization Rate ◽  
University Hospital ◽  
P Value ◽  
Potentially Inappropriate Medications

AbstractPurposeTo examine the association between potentially inappropriate medications (PIMs) use and the hospitalization rate in elderly Thai patients.MethodsIn this retrospective cohort study, we collected the electronic medical data of elderly patients aged 60 years and older who visited the outpatient department (OPD) at Thammasat University Hospital in Thailand in 2015. The patients were categorized into PIM and non-PIM users according to the Beers 2019 criteria. We calculated descriptive statistics for demographic variables. We also examined the association between PIM use and various different factors with hospitalization rate during follow-up using log-binomial regression. We calculated the relative risk for association between PIM use and other factors with the hospitalization rate.ResultsWe collected data for a total of 32,261 patients. The majority of participants were female (59.65%) and had a mean age of 70.21 years (SD=7.88). Overall, 63.98% of the patients (n=20,641) were PIM users and 49.45% (n=15,952) received polypharmacy (≥5 medications). The most common PIM prescription was proton-pump inhibitors, which were 27.51% of all medications prescribed. We found that PIM use increased the risk of hospitalization by 1.31 times (adjusted RR=1.31, 95% CI: 1.21 – 1.41, p-value < 0.001). Other factors associated with a higher rate of hospitalizations included older age, male gender, polypharmacy, and a higher number of OPD visits.ConclusionPIMs were commonly prescribed to the elderly in the OPD, and were significantly associated with subsequent hospitalization. The provision of an alternative drug list can help physicians avoid prescribing PIMs to the elderly. If PIMs prescription is unavoidable, physicians should closely monitor patients for drug-related problems and deprescribe PIMs when they are no longer indicated.

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