BACKGROUND

Deep vein thrombosis is more common in elderly people compared to general population. On the other hand, anticoagulant therapy is followed by higher risk of hemorrhagic complications in these patients.

OBJECTIVE

To determine the incidence and severity of hemorrhagic complications in elderly and senile patients with deep vein thrombosis on anticoagulation.

MATERIAL AND METHODS

There were 140 patients over 60 years old with confirmed deep vein thrombosis of the lower extremities. The sample included 46.4% of men and 53.6% of women. Mean age was 74.2±8.7 years. Patients were divided into elderly (60—74 years) and senile (75—90 years) ones. Moreover, we distinguished 3 groups of anticoagulation: heparin + warfarin, rivaroxaban and apixaban. Incidence and severity of hemorrhagic complications, as well as bleeding-free period was analyzed.

RESULTS

Overall rate of bleeding was 23.6% (n=33). Non-major clinically significant bleeding developed in 6.4% of patients, minor events — in 17.1% of cases. No major bleeding occurred. Short-term nosebleed (6.4%) and hematuria (3.6%) were the most common events. Anticoagulation with warfarin and rivaroxaban was accompanied by similar rates of non-major clinically significant bleeding (7.7% and 7.6%, respectively). In case of apixaban, these adverse events were absent. Mean bleeding-free period was 2—3 months.

CONCLUSION

Any type of anticoagulation is associated with high risk of bleeding within 3 months of therapy in elderly and senile patients with deep vein thrombosis. Apixaban is associated with a lower incidence of hemorrhagic complications.