居住在社区的心房颤动老年人的抗凝模式。

IF 3 Q1 PRIMARY HEALTH CARE
Meaghan Costello, Ericka E Tung, Karen M Fischer, Thomas M Jaeger
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引用次数: 0

摘要

目的评估临床医生为患有心房颤动或心房扑动(AF/F)的老年人开具抗凝处方的做法,并确定未进行抗凝治疗的老年人的常见因素:我们对 65 岁及以上、有非瓣膜性心房颤动/心房扑动病史的成年人进行了一项基于社区的回顾性队列研究,以确定口服抗凝药物的使用率。我们还评估了抗凝药物使用与合并症和常见老年综合征之间的关联:共纳入了 3832 名诊断为非瓣膜性房颤/房颤的患者(平均 [SD] 年龄为 79.9 [8.4] 岁),其中 2693 人(70.3%)正在接受抗凝治疗(51.7% 接受维生素 K 拮抗剂治疗;48.1% 接受直接作用口服抗凝剂治疗)。老年风险评估指数(ERA)评分较高的患者比评分较低的患者更少接受抗凝治疗,ERA 是健康脆弱性的代用指标。未接受抗凝治疗的患者中有跌倒史的比例高于接受抗凝治疗的患者(44.4% 对 32.8%;P P 结论:相当一部分患有房颤/膀胱结石的老年人没有接受抗凝治疗。根据较高的ERA评分,未接受抗凝治疗的老年人健康状况恶化的风险更高,痴呆症和跌倒史的发生率也更高。这表明,老年综合征的存在可能会影响暂停抗凝治疗的决定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anticoagulation Patterns Among Community-Dwelling Older Adults With Atrial Fibrillation.

Objectives: To assess clinicians' prescribing practices for anticoagulation in older adults with atrial fibrillation or atrial flutter (AF/F) and determine factors common among those without anticoagulation.

Methods: We performed a community-based retrospective cohort study of adults aged 65 years and older with a history of nonvalvular AF/F to determine the rate of oral anticoagulation utilization. We also assessed for associations between anticoagulation use and comorbid conditions and common geriatric syndromes.

Results: A total of 3832 patients with a diagnosis of nonvalvular AF/F were included (mean [SD] age, 79.9 [8.4] years), 2693 (70.3%) of whom were receiving anticoagulation (51.7%, a vitamin K antagonist; 48.1%, a direct-acting oral anticoagulant). Patients with higher Elderly Risk Assessment index (ERA) scores, a surrogate for health vulnerability, received anticoagulation less often than patients with lower scores. The percentage of patients with a history of falling was higher among those who did not receive anticoagulation than among those who did (44.4% vs 32.8%; P < .001). Similarly, a diagnosis of dementia was more common in the no-anticoagulation group than the anticoagulation group (18.5% vs 12.7%; P < .001).

Conclusions: A substantial proportion of older adults with AF/F do not receive anticoagulation. Those without anticoagulation had higher risk of health deterioration based on higher ERA scores and had a higher incidence of dementia and fall history. This suggests that the presence of geriatric syndromes may influence the decision to withhold anticoagulation.

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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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