Old age and VTE

Age is the main thrombosis and pulmonary embolism risk factor. Most patients with VTE are more than 65 years of age

Venous thromboembolic disease (VTE) is more common the older a person gets. The formation of thrombi (blood clots) in the veins of the legs, capable of spreading to the heart and dislodging and causing a pulmonary embolism, is a process that is clearly favoured by ageing.

The majority of people with VTE in developed countries are over 65 years of age, leading to an extraordinary increase in the number of cases of older patients with VTE, a problem that will increase exponentially in the very near future.

As age increases, so does the severity of VTE. That is, more often their venous thromboses are more extensive, more often the disease debuts as a pulmonary embolism, and these pulmonary embolisms in older patients tend to be more severe than those in younger patients.

Immobilisation, a major risk

In old age patients the main triggering factor of VTE is  prolonged immobilization, usually related to degenerative osteoarticular processes, loss of secondary forcesor brain stroke, and often with dementia.

Elderly patients with VTE often suffer from associated chronic diseases making VTE diagnosis difficult, at times. Symptoms sometimes overlap and are confused or misinterpreted which may worsen their prognosis.

The same pulmonary embolism can have very few symptoms in a 30-year-old person or be very serious in an 80-year-old patient with heart or lung disease.

Treatments with anticoagulant drugs present a much higher risk of bleeding complication in these patients.The doctor must always consider this condition when prescribing drugs.

However, being an elderly person, even at a very advanced age, should never be a reason to not use anticoagulant drugs. In all cases the risk/benefit of the use of these drugs should be assessed individually.Prevention is essential in the elderly who run the risk of suffering VTE, usually by administering subcutaneous injections of low molecular weight heparin.