Long-term follow-up results and risk factors of bleeding among very elderly patients with non-valvular atrial fibrillation
10.3760/cma.j.cn114798-20230305-00181
- VernacularTitle:高龄老年NVAF患者血栓栓塞和出血事件的长期随访结果及其出血事件的危险因素分析
- Author:
Yuhui CHEN
1
;
Tao GONG
;
Lei XU
;
Fang LIU
;
Wei LI
;
Yin WANG
;
Yinhong LIU
Author Information
1. 国家老年医学中心 中国医学科学院老年医学研究院 北京医院神经内科 北京医院保健医疗部，北京100730
- Keywords:
Atrial fibrillation;
Thromboembolism;
Hemorrhage;
The oldest old
- From:
Chinese Journal of General Practitioners
2023;22(5):480-485
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the long-term follow-up results and the risk factors of bleeding among very elderly patients with non-valvular atrial fibrillation (NVAF).Methods:A total of 177 patients with NVAF admitted in Beijing Hospital from January 2016 to July 2016 were enrolled in the study, including 107 very elderly patients (aged≥80 years) and 70 elderly patients (aged 65-80 years). The demographic information, comorbid diseases, lifestyles, antithrombotic therapy, thromboembolism risks, bleeding risks, and medical history were documented. Patients were followed up for 5 years and the events of death, thromboembolism, bleeding and major bleeding were recorded.Results:There was no significant difference in the incidence of thromboembolic events between the two groups (15.9%(17/107) vs. 14.3%(10/70), P>0.05). The proportions of bleeding events and severe bleeding events in the very elderly group were higher than those in the elderly group (45.8%(49/107) vs.10.0%(7/70), 14.0%(15/107) vs. 1.4%(1/70), both P<0.05). According to the bleeding events during follow-up, very elderly patients were divided into bleeding group ( n=49) and non-bleeding group ( n=58). Compared with the non-bleeding group, patients in the bleeding group had an older age, a higher proportion of chronic cardiac insufficiency, chronic kidney disease, malignant tumor, bleeding history and higher bleeding risk score (HAS-BLED score) (all P<0.05). Multivariate logistic regression model analysis showed that age, HAS-BLED score, history of bleeding, and complicated malignant tumor were independent risk factors for bleeding events in very elderly patients with NVAF (all P<0.05). Conclusions:Very elderly patients with NVAF have a similar risk of thromboembolism compared with the younger elderly, but have significantly higher risk of the bleeding and major bleeding. Age, HAS-BLED score, bleeding history, and malignant tumor are independent risk factors for bleeding events in very elderly NVAF patients.
