Journal of vascular surgery · 2025
Association of age on thromboelastography coagulation profiles among elderly patients with peripheral arterial disease.
СтатьяНаблюдательное исследованиеСравнительное исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Rodriguez Alvarez Adriana A, Cieri Isabella Ferlini, Morrow Katherine L, Boya Mounika Naidu, Suarez Ferreira Sasha P, Patel Shiv S, Dua Anahita
Аннотация
OBJECTIVE: This study aimed to determine whether age affects thromboelastography (TEG) coagulation profiles among elderly patients with peripheral arterial disease. We hypothesized that TEG parameters would not significantly differ between age groups when controlled for anticoagulation regimen.
METHODS: This was a prospective, single-institution, observational study that included patients aged 65 years and older who underwent open or endovascular lower extremity revascularization for peripheral arterial disease from December 2020 through December 2023. A total of 158 patients were grouped into categories: by age (65 to 74 years and 75+ years) and anticoagulation regimen (single antiplatelet [50%], dual antiplatelet [15%], therapeutic anticoagulation [27%], none [8%]). Objective TEG coagulation profiles were collected preoperatively and were compared among patient groups. One-way analysis of variance was used to compare three or more groups of continuous data, and χ2 analysis or Fisher exact test were used to compare categorical data.
RESULTS: Among 158 patients (36.4% female; median age, 74.5 ± 6.6 years), there were no significant differences in TEG parameters (reaction time, maximum amplitude, lysis at 30 minutes, angle, adenosine diphosphate % aggregation, adenosine diphosphate % inhibition) between age groups when stratified by anticoagulation regimen (all P > .05). Thrombosis rates were similar between age groups (21.1% vs 20.6%; P = .936), but mortality was significantly higher in the 75+ group (20.6% vs 5.6%; P = .005).
CONCLUSIONS: Objective coagulation parameters do not appear to vary significantly among age groups within the elderly population when controlled for antiplatelet/anticoagulant regimen. TEG profiles may be used to guide anticoagulation management among elderly patients. Further studies can help elucidate the full utility of TEG profiles for coagulation surveillance among elderly patients.
METHODS: This was a prospective, single-institution, observational study that included patients aged 65 years and older who underwent open or endovascular lower extremity revascularization for peripheral arterial disease from December 2020 through December 2023. A total of 158 patients were grouped into categories: by age (65 to 74 years and 75+ years) and anticoagulation regimen (single antiplatelet [50%], dual antiplatelet [15%], therapeutic anticoagulation [27%], none [8%]). Objective TEG coagulation profiles were collected preoperatively and were compared among patient groups. One-way analysis of variance was used to compare three or more groups of continuous data, and χ2 analysis or Fisher exact test were used to compare categorical data.
RESULTS: Among 158 patients (36.4% female; median age, 74.5 ± 6.6 years), there were no significant differences in TEG parameters (reaction time, maximum amplitude, lysis at 30 minutes, angle, adenosine diphosphate % aggregation, adenosine diphosphate % inhibition) between age groups when stratified by anticoagulation regimen (all P > .05). Thrombosis rates were similar between age groups (21.1% vs 20.6%; P = .936), but mortality was significantly higher in the 75+ group (20.6% vs 5.6%; P = .005).
CONCLUSIONS: Objective coagulation parameters do not appear to vary significantly among age groups within the elderly population when controlled for antiplatelet/anticoagulant regimen. TEG profiles may be used to guide anticoagulation management among elderly patients. Further studies can help elucidate the full utility of TEG profiles for coagulation surveillance among elderly patients.