Prevention of Venous Thromboembolism in the Elderly
Gena Piliotis, MD1
William H. Geerts, MD1,2
1Departments of Medicine and
2Health Policy, Management and Evaluation;
Sunnybrook & Women's College Health Sciences Centre,
University of Toronto, Toronto, ON.
Abstract
Venous thromboembolism is predominantly a disease of the elderly. However, geriatric patients often fail to receive appropriate thromboprophylaxis because of under-recognition of age as an important risk factor for thromboembolism and perhaps, in part, because of the perception of a greater potential for bleeding complications associated with anticoagulants. Although there is a paucity of literature specifically addressing thromboprophylaxis in geriatric populations, it is suggested that elderly patients with thromboembolic risk factors receive similar prophylaxis to that recommended for younger patients with the same risk factors. Routine prophylaxis should, therefore, be provided to elderly patients undergoing general, urologic and gynecologic surgery, neurosurgery, hip or knee arthroplasty, surgery for hip fracture, to those who experience major trauma, and to elderly patients with acute medical illnesses plus additional risk factors.