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Journal article : Review

Antithrombotics in trauma: management strategies in the older patients

Abstract:
The ageing population has resulted in a change in the demographics of trauma, and older adult trauma now accounts for a growing number of trauma admissions. The management of older adult trauma can be particularly challenging, and exhibits differences to that of the younger age groups affected by trauma. Frailty syndromes are closely related with falls, which are the leading cause of major trauma in older adults. Comorbid disease and antithrombotic use are more common in the older population. Physiological changes that occur with ageing can alter the expected clinical presentation of older persons after injury and their susceptibility to injury. Following major trauma, definitive control of hemorrhage remains essential for improving outcomes. In the initial assessment of an injured patient, it is important to consider whether the patient is taking anticoagulants or antiplatelets and if measures to promote hemostasis such as reversal are indicated. After hemostasis is achieved and bleeding has stopped, longer-term decisions to recommence antithrombotic agents can be challenging, especially in older people. In this review, we discuss one aspect of management for the older trauma patients in greater detail, that is, acute and longer-term management of antithrombotic therapy. As we consider the health needs of an ageing population, rise in elderly trauma and increasing use of antithrombotic therapy, the need for research in this area becomes more pressing to establish best practice and evidence-based care.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.2147/JBM.S125209

Authors


More by this author
Division:
MSD
Department:
RDM
Sub department:
RDM Clinical Laboratory Sciences
Role:
Author


Publisher:
Dove Medical Press
Journal:
Journal of Blood Medicine More from this journal
Volume:
8
Issue:
2017
Pages:
165-174
Place of publication:
New Zealand
Publication date:
2017-10-04
Acceptance date:
2017-08-25
DOI:
EISSN:
1179-2736
Pmid:
29042825


Language:
English
Keywords:
Subtype:
Review
Pubs id:
738902
Local pid:
pubs:738902
Deposit date:
2020-03-06

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