Venous thromboembolism in older adults: A community-based study.
BACKGROUND
While the incidence of venous thromboembolism increases with age, little is known about its contemporary management or outcomes in older patients. Our goal was to compare the characteristics, treatment, and outcomes associated with venous thromboembolism, in patients aged 65-69 years, 70-74 years, 75-79 years, and 80+ years.


METHODS/PARTICIPANTS
We prospectively followed 542 subjects aged ≥65 years with venous thromboembolism from January 2008 through August 2011 at 6 sites. In addition, a retrospective study of 681 additional subjects aged ≥65 years with venous thromboembolism diagnosed in 2007 and 2009 was conducted at the same 6 sites.


RESULTS
With advancing age, patients were more likely to suffer provoked venous thromboembolism but less likely to present with pulmonary embolism. Patients with unprovoked, provoked, or malignancy-associated venous thromboembolism received warfarin for a median of 401 days, 203 days, and 529 days, respectively. Age ≥80 years was not associated with an increased risk of recurrent venous thromboembolism, but there was an increased risk of all-cause mortality.


CONCLUSION
With advancing age, patients are more likely to suffer hospital-associated and provoked venous thromboembolism. Many elderly patients with provoked or unprovoked venous thromboembolism were treated for >3 months or >12 months, respectively. Given that advanced age was not associated with increased risk of recurrent venous thromboembolism, but elderly patients in general have a higher risk of bleeding from continued anticoagulant therapy, such practice is potentially harmful. At the same time, such an argument could be used to more vigorously offer prophylaxis in the first place.
['Spencer|Frederick A|FA|', 'Gurwitz|Jerry H|JH|', 'Schulman|Sam|S|', 'Linkins|Lori-Ann|LA|', 'Crowther|Mark A|MA|', 'Ginsberg|Jeffrey S|JS|', 'Lee|Agnes Y Y|AY|', 'Saczynski|Jane S|JS|', 'Anand|Sonia|S|', 'Lessard|Darleen|D|', 'Emery|Cathy|C|', 'Huang|Wei|W|', 'Goldberg|Robert J|RJ|']
D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D000925:Anticoagulants D004334:Drug Administration Schedule D005260:Female D005500:Follow-Up Studies D006470:Hemorrhage D006801:Humans D008297:Male D016016:Proportional Hazards Models D011446:Prospective Studies D012008:Recurrence D012189:Retrospective Studies D012307:Risk Factors D016896:Treatment Outcome D054556:Venous Thromboembolism D014859:Warfarin
Aged Pulmonary embolism Elderly Deep vein thrombosis