Braun S, Chamorro G, Wilson C, Casanegra P, Corbalán R, Iirarrázaval M J, Kobus C, Valle I
Departamento de Enfermedades Cardiovasculares, Hospital Clínico, Pontificia Universidad Católica de Chile, Santiago.
Rev Med Chil. 1992 May;120(5):552-8.
To assess age-related risks of long term anticoagulation, the records of 348 patients followed up at our university hospital outpatient anticoagulation clinic during a seven year period were reviewed. There were 129 patients, under 56 years of age, 144 from 56 to 69 and 75 over 70 years old. The total observation period was 1089 patient-years (3.3 yrs per pt). 64% of the patients had adequate anticoagulation level (prothrombin time < 35%, INR 2.2-4.5) 70 to 100% of the observation period. Prothrombin time was slightly, but significantly higher in the elderly group. During this period 21 patients developed major bleeding complications (1.84/100 pt yrs), 8 of them with fatal intracranial hemorrhages, and 20 embolic complications (1.93/100 pt yrs), 3 of them fatal. No significant differences in the incidence of both bleeding and embolic complications were observed in the three groups. The results of this retrospective follow-up study suggest that long term anticoagulation can be carried out in elderly pts with risk of hemorrhagic and embolic complications similar to those observed in the general population.
为评估长期抗凝治疗与年龄相关的风险，我们回顾了在大学医院门诊抗凝门诊随访7年的348例患者的记录。其中129例患者年龄在56岁以下，144例年龄在56至69岁之间，75例年龄超过70岁。总观察期为1089患者年（每位患者3.3年）。64%的患者在70%至100%的观察期内抗凝水平适宜（凝血酶原时间<35%，国际标准化比值2.2 - 4.5）。老年组的凝血酶原时间略高，但差异有统计学意义。在此期间，21例患者发生严重出血并发症（1.84/100患者年），其中8例为致命性颅内出血；20例发生栓塞并发症（1.93/100患者年），其中3例致命。三组患者在出血和栓塞并发症的发生率上均未观察到显著差异。这项回顾性随访研究的结果表明，老年患者若有出血和栓塞并发症风险，可进行长期抗凝治疗，其风险与普通人群相似。
