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Cardiol Clin. 2008 May;26(2):221-34, vi. doi: 10.1016/j.ccl.2007.12.008.

Prevention of venous thromboembolism in the geriatric patient.

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  • 1Hospitalist Program, The Johns Hopkins Hospital, Park 307, 600 North Wolfe Street, Baltimore, MD 21287, USA.


Elderly patients immobilized because of an acute medical illness or surgery have a very high risk of developing venous thromboembolism (VTE). Aggressive pharmacologic prophylaxis is necessary and should be initiated either at admission for a medical condition or shortly after surgery. Aggressive prophylaxis may result in fewer patients developing VTE in the hospital and ultimately lead to fewer patients requiring full-dose anticoagulation for VTE. Mechanical prophylaxis can be used as an adjunct to an anticoagulant-based regimen but should only be used as primary prophylaxis when there is a contraindication, such as active bleeding. It is recommended that the clinician carefully evaluate the elderly patient's creatinine clearance and weight before prescribing anticoagulants, particularly when using fixed dosing regimens.

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