Deep venous thrombosis and pulmonary embolism in geriatric medicine – two sides of the same coin
Authors:
P. Weber; D. Weberová; P. Ambrošová; H. Meluzínová; K. Bielaková; H. Matějovská Kubešová
Authors‘ workplace:
Klinika interní, geriatrie a praktického lékařství LF MU a FN Brno-Bohunice
Published in:
Kardiol Rev Int Med 2012, 14(1): 17-21
Overview
The patients of advanced age whose number has been growing represent a highly heterogeneous group with very different health problems and miscellaneous clinical characteristics of many very often totally different diseases. Pulmonary embolism in the elderly represents immediate threat of life. Especially in old age clinical signs of pulmonary embolism are non-specific and could be both underdiagnosed and overdiagnosed. Optimal intensive treatment of the elderly should remove symptoms of the disease, achieve sufficient compensation of somatic status and prevent from complications. Their course of pulmonary embolism is more difficult and severe with higher mortality in comparison to younger people. In very old people with frailty and geriatric giants pulmonary embolism is relatively often occasional finding as cause for the death by obduction without any previous clinical symptoms. Thrombembolism is the most common cause of sudden death, and a major cause of morbidity, in later life. The incidence of venous thrombembolism increases exponentially with age. Since the inpatient mortality in general hospitals is about 10%, it is estimated that about 1% of patients admitted to the hospital die of pulmonary embolism. However, for every patient who dies of pulmonary embolism in a surgical ward, three die in nonsurgical wards. In the great majority of patients dying of pulmonary embolism, previous venous thrombembolism was not diagnosed or treated.
Keywords:
advanced age – multi-morbidity – pulmonary embolism – deep venous thrombosis – diagnostics – therapy
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