The impact of frailty on coagulation and responses to warfarin in acute older hospitalised patients with atrial fibrillation: a pilot study
The impact of frailty on coagulation and responses to warfarin in acute older hospitalised patients with atrial fibrillation: a pilot study
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虚弱对老年急性心房颤动住院患者凝血和华法林反应的影响：一项初步研究
DOI：
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发表时间：
2017
影响因子：
4
通讯作者：
C. Ward
中科院分区：
文献类型：
--
作者：
T. Nguyen;M. Morel;Dominic Pepperell;R. Cumming;S. Hilmer;C. Ward
研究背景虚弱与凝血功能改变的证据并不一致，临床研究表明虚弱的老年人在接受抗凝治疗时可能会增加出血并发症的风险。目的本研究旨在评估虚弱对凝血功能的影响以及对华法林的反应。使用报告的埃德蒙顿脆弱度量表来确定脆弱程度。结果95名受试者的数据被分析，平均年龄85.5 ± 6.2，女性40%，虚弱50.5%。在没有服用抗凝剂(N = 36)的受试者中，与当地设定的正常范围相比，年轻健康志愿者的纤维蛋白生成增加，凝血酶生成减少；体弱者与非体弱者相比，纤维蛋白生成显著减少。在华法林治疗组(N = 59)中，在任何凝血试验中，虚弱的和非虚弱的凝血特性没有差异。结论在这组急性住院的房颤患者中，观察到的虚弱的纤维蛋白生成减少可能反映了急性期反应的降低，这可能与该组血浆纤维蛋白原的降低有关。在服用华法林的患者中，虚弱患者和非虚弱患者的凝血谱没有差异。与年轻的健康志愿者相比，老年住院患者的纤维蛋白生成增加，凝血酶生成减少。这些发现反映了年龄、虚弱、急性疾病和凝血之间的复杂相互作用。
BackgroundThe evidence on coagulation changes with frailty is not consistent and clinical studies suggest that frail older people may be at an increased risk of bleeding complications with anticoagulant therapy.AimsThis study aims to assess the impact of frailty on coagulation function and on response to warfarin.MethodsInpatients aged over 65 years with atrial fibrillation (AF) were recruited. Frailty was determined using the Reported Edmonton Frail Scale. The Overall Haemostatic Potential (OHP) and Calibrated Automated Thrombogram (CAT) were used to globally assess coagulation function.ResultsData of 95 participants were analysed, mean age 85.5 ± 6.2, 40% female, and 50.5% frail. Among participants not on anticoagulants (N = 36), there was an increased fibrin generation and decreased thrombin generation compared to the local established normal ranges in young healthy volunteers; the frail had significantly reduced fibrin generation compared to the non-frail. In the warfarin-treated group (N = 59), there was no difference on coagulation profiles between the frail and the non-frail from any of the coagulation tests.ConclusionIn this cohort of acute hospitalised patients with AF, the observed decreased fibrin generation in the frail may reflect decreased acute phase response as suggested with the lower plasma fibrinogen in that group. There was no difference in coagulation profiles between the frail and the non-frail amongst those taking warfarin. Compared to young healthy volunteers, older inpatients had increased fibrin generation and decreased thrombin generation. The findings reflect the complex interaction between age, frailty, acute illness, and coagulation.
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影响因子：
5.9
作者：
Cohen, HJ;Harris, T;Pieper, CF
通讯作者：
Pieper, CF
影响因子：
--
作者：
Walston, J;McBurnie, MA;Fried, LP
通讯作者：
Fried, LP
影响因子：
10.4
作者：
Mann, KG;Brummel, K;Butenas, S
通讯作者：
Butenas, S
DOI：
10.1093/gerona/60.6.729
发表时间：
2005-06-01
影响因子：
5.1
作者：
Chaves, PHM;Semba, RD;Fried, LP
通讯作者：
Fried, LP
影响因子：
24
作者：
January, Craig T.;Wann, L. Samuel;Yancy, Clyde W.
通讯作者：
Yancy, Clyde W.