[Factors of therapeutic imbalance of antivitamins K and their haemorrhagic consequences in elderly]. / Les facteurs de déséquilibre thérapeutique des antivitamines K et leurs conséquences hémorragiques en pratique gériatrique.
Therapie
; 63(5): 393-401, 2008.
Article
em Fr
| MEDLINE
| ID: mdl-19154709
ABSTRACT
Objective. To determinate, for older subjects, specific factors of imbalance of the oral anticoagulant treatments. Method. We conducted an epidemiological and analytical case-control study, during 18 months, in 2 geriatrics centers. Each patient with excessive anticoagulation (INR>4.5) was matched with 2 controls under anticoagulant, whom the INR (international normalized ratio) had stayed in the therapeutic range. Results. One-hundred fifty nine subjects (53 cases and 106 controls) were included. Haemorrhagic complications has been observed in 19.2% of cases, versus 3.9% of the controls. Some medicines frequently prescribed to the old subjects were correlated at a risk of excessive anticoagulation amiodarone (9.4% versus 0, p<0.004), acetaminophen (18.9% versus 0.9%, p<0.001), tramadol (5.6% versus 0, p<0.04), ofloxacine (11.3% versus 1.9%, p<0.001), and lactulose (11.3% versus 0, p<0.001). Furthermore, several acute states increase the risk of excessive INR to the old subjects:
fever (p<0.001), malnutrition (p<0.001), dehydration (p=0.006), and acute diarrhea (p<0.001). Conclusion. Some specific geriatric factors raised may destabilize treatments by anticoagulants.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vitamina K
/
Hemorragia
/
4-Hidroxicumarinas
/
Indenos
/
Anticoagulantes
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
Fr
Revista:
Therapie
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
França