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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Management of oral anticoagulant in clinical practice: a retrospective study of 187 patients.
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Management of oral anticoagulant in clinical practice: a retrospective study of 187 patients.

机译：临床实践中口服抗凝剂的管理：回顾性研究187例患者。

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Oral anticoagulant (OA) therapy is widely used in elderly patients because of the increase of indications with age (venous thromboembolism and atrial fibrillation). A particularity of France is to administer three different OAs (warfarin and more often fluindione or acenocoumarol). In an attempt to assess the particularities of managing all three OAs in elderly patients in clinical practice, we studied the modalities of anticoagulation of 187 consecutive OA therapy patients (mean age = 74.4 years) hospitalized in an Internal Medicine department (95 patients on OA at admission and 92 patients initiated on OA during hospitalization). Patients aged 75 years or older more often required a low dosage of OA than those aged younger than 75, irrespective of the OA (warfarin and more often fluindione or acenocoumarol). Ambulatory patients aged 75 years or older were more susceptible to receive acenocoumarol than were ambulatory patients younger than 75 years (respectively 30/67 vs 8/28, respectively), whereas fluindione was prescribed at the same frequency in ambulatory patients and hospitalized patients, regardless of age group (> or =75: 32/67; <75: 19/28). In hospitalized patients with OA induction, fluindione was prescribed as often in patients younger than 75 than in patients aged 75 years or older (40/47 vs 35/45, respectively). On admission, international normalized ratio was in the target range in 26 of the 95 patients (27.4%) and was >3 in 51 of the 95 patients (51.6%). OA therapy was stopped during hospitalization in 35 patients (36.8%). In conclusion, we have a picture of the practice of anticoagulation with three different OA therapies. Although it is usually recommended to prescribe long half-time OA therapy (2), it appears that short half-time therapy such as acenocoumarol still represents an important number of OA prescriptions in France, especially in ambulatory and elderly patients. International normalized ratio is not in the target range as often as expected in clinical practice, and elderly patients require specific modalities of OA therapy management, such as half dose initiation, use of long-half-life OA, and close monitoring.
机译：由于适应症随着年龄的增长（静脉血栓栓塞和心房颤动）增加，所以口服抗凝剂（OA）治疗被广泛用于老年患者。法国的特殊之处是要管理三种不同的OA（华法林，更常见的是氟啶二酮或乙酰香豆酚）。为了评估在临床实践中管理老年患者的所有三种OA的特殊性，我们研究了内科中住院的187例连续OA治疗患者（平均年龄= 74.4岁）的抗凝方式（95例接受OA治疗的患者）住院期间有92例患者开始接受OA）。与年龄在75岁以下的患者相比，年龄在75岁或以上的患者更需要低剂量的OA，而不论OA（华法林，更常见的是氟啶二酮或乙酰香豆酚）。与年龄在75岁以下的门诊患者相比，年龄在75岁或以上的门诊患者更容易接受乙酰香豆酚（分别为30/67和8/28），而在门诊患者和住院患者中，氟丁酮的处方频率相同年龄组（>或= 75：32/67; <75：19/28）。在住院的OA诱导患者中，未满75岁的患者比75岁或以上的患者经常开出fluindione（分别为40/47和35/45）。入院时，国际标准化比率在95例患者中的26例（27.4％）处于目标范围内，在95例患者中的51例（51.6％）中大于3。住院期间停止进行OA治疗的患者为35例（36.8％）。总之，我们对三种不同的OA治疗的抗凝治疗方法有了一个了解。尽管通常建议开长时间的半衰期OA疗法（2），但在法国，短时间的半衰期疗法，例如乙酰香豆酚，仍然代表着大量的OA处方，尤其是在非卧床和老年患者中。国际标准化比率未达到临床实践中预期的目标范围，并且老年患者需要特定的OA治疗管理方式，例如半剂量起始，使用半衰期OA和密切监测。

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