Beyth R J
Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Clin Geriatr Med. 2001 Feb;17(1):49-56. doi: 10.1016/s0749-0690(05)70105-1.
Hemorrhage is the major complication of anticoagulant therapy. The criteria for classifying the severity of bleeding has varied between studies, which has resulted in variability in the rate of bleeding reported in the literature. The major determinants of oral anticoagulant-related bleeding are the intensity of the anticoagulant effect, baseline patient characteristics, and the length of therapy. Older patients have characteristics that may place them at higher risk for anticoagulant-related bleeding, but they also have characteristics that make them more likely to benefit. The risk for anticoagulant-related bleeding cannot be considered in isolation and the potential benefits need to be weighed carefully in each individual patient, irregardless of age.
出血是抗凝治疗的主要并发症。不同研究中出血严重程度的分类标准有所不同,这导致文献报道的出血发生率存在差异。口服抗凝剂相关出血的主要决定因素是抗凝效果的强度、患者的基线特征以及治疗时长。老年患者具有一些可能使其发生抗凝剂相关出血风险更高的特征,但他们也有一些更可能从中获益的特征。不能孤立地考虑抗凝剂相关出血的风险,无论年龄大小,都需要在每个患者身上仔细权衡潜在的获益。