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Marty

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Risks associated with blood thinners rise with age Jul 15 (Reuters Health) - The risk of bleeding and thromboembolism (blood clots) in people who use anticoagulants increases with age, according to a new study.
Anticoagulant medications such as Coumadin (warfarin) thin the blood and help prevent clots from forming or growing larger, thereby cutting the risk of heart attack and the type of stroke caused by artery blockages.

"Anticoagulant treatment in elderly patients presents a major clinical dilemma," write Dr. Frits R. Rosendaal and colleagues in the Archives of Internal Medicine. While the risk of blood clots and the subsequent need for proper anticoagulant drug therapy increases sharply with age, the bleeding risk rises as well.

Rosendaal, from Leiden University Medical Center in the Netherlands, and colleagues studied the risk of bleeding and embolism in roughly 4,200 patients who were treated with an oral anticoagulant between 1994 and 1998. Nearly 700 of them were more than 80 years of age.

They found that the incidence of major bleeding increased sharply with advancing age. The oldest patients were 2.7 times more likely to experience a major bleeding event than the youngest patients. The risks of blood clots also increased with advancing age.

Rosendaal and colleagues suggest that older patients using anticoagulant medication may need more frequent monitoring by their doctor with a blood test called an INR. Doctors use this test to ensure that the dose of anticoagulant being given is not thinning the blood too much or too little.

SOURCE: Archives of Internal Medicine, July 11, 2005.


Publish Date: July 15, 2005
 
I don't really think so, but look at how lousy most Coumadin dosing is done. Until everyone is on the same page, I imagine we are going to see this type of thing happening. The elderly are a class of their own and most likely receive the least amount of PROPER care to be given.
 
Ross said:
The elderly are a class of their own and most likely receive the least amount of PROPER care to be given.

And are the least likely to question a doctor's knowledge. We've all seen how many doctors lack an accurate understanding of warfarin management.
 
it might be true. Brother simply bumped his toe in the shower and within a couple hours I had him at the ER with a purple, blotchy foot/ankle up to here - a bleed. That hasn't happened to him before with a small bump like that - he is unable to maneuver himself well and often gets a bump. So this rather scares me.

His dr is very good about monitoring his INR and for that I am very thankful.

Thank you Marty for this information.
 
Thanks for sharing this interesting and informative article Marty!

This would be a good thread to move to the Anti-Coagulation Forum with a more topical title for ease of future reference.

'AL Capshaw'
 
You know Marty, even given that most people are not being seen by a truly on the page anticoag expert, I do think there is some truth to the study anyhow. I was thinking back to my dad and how during his last few years with us, developed all sorts of subdural bleeds. He wasn't on Coumadin either.
 
Older warfarin users

Older warfarin users

I agree Ross. Everything gets worse as you get older and the risks of
anticoagulation increase too. I'm not sure even the best doctors and pharmacists managing the anticoagulants can ward off all complications. Heck, I have an MD and self manage and I've had two bleeds. One into my right retina and the other into my left thigh. There's a lot of chance to it and I'm happy I havn't had any intracranial problems so far. They are the worst.
 
The sad thing is that The Netherlands has the best warfarin management in the world and this still happens. All of their medical care is government paid (by taxes) and everyone on anticoagulants are assigned to special clinics. We will not duplicate this in the US in the lifetime of any member on this site.

Whether or not a treatment is worthwhile is always subject to interpretation. However, most authorities agree that older people have a higher risk of clotting and that the increased risk of bleeding is outweighed by the benefit of not having a stroke. The old brain cells vs blood cells comparison again.
 

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