Roller Regina E, Iglseder Bernhard, Dovjak Peter, Lechleitner Monika, Sommeregger Ulrike, Benvenuti-Falger Ursula, Otto Ronald, Böhmdorfer Birgit, Gosch Markus
Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Austria.
Universitätsklinik für Geriatrie, Paracelsus Medizinische Privatuniversität, Salzburg, Austria.
Wien Med Wochenschr. 2010 Jun;160(11-12):270-275. doi: 10.1007/s10354-010-0785-2.
Oral anticoagulant therapy has been shown to be of benefit also in elderly patients in various therapeutic and prophylactic indications. Despite strong evidence in literature, doctors still refuse to prescribe oral anticoagulants to geriatric patients in daily routine. Main reason for this decision is the fear of secondary bleeding complications. According to clinical trial data, distinct risk factors for bleeding attributed to anticoagulant treatment may be determined: age >70 years, female gender, recurrent bleeding events, alcohol/drug abuse, diabetes, anaemia and polypharmacy. The entire article reveals the literature in Medline and Cochrane Library from 1980 to 2009 including the hits "polypharmacy - anticoagulant treatment - elderly patients". It further highlights risk assessment strategies in elderly patients, and possible pharmacokinetic and -dynamic interactions of drugs co-administered with oral anticoagulants.
口服抗凝治疗已被证明在各种治疗和预防适应症的老年患者中也有益处。尽管文献中有充分的证据，但医生在日常工作中仍拒绝为老年患者开口服抗凝药。做出这一决定的主要原因是担心继发性出血并发症。根据临床试验数据，可以确定抗凝治疗导致出血的明显危险因素：年龄>70岁、女性、反复出血事件、酒精/药物滥用、糖尿病、贫血和多重用药。整篇文章检索了1980年至2009年Medline和Cochrane图书馆中的文献，包括“多重用药-抗凝治疗-老年患者”的相关文献。它进一步强调了老年患者的风险评估策略，以及与口服抗凝药联合使用的药物可能存在的药代动力学和药效学相互作用。
