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Master Thesis

Fibrillation auriculaire non valvulaire et traitement anticoagulant chez les personnes âgées de 75 ans et plus hospitalisées en court séjour gériatrique du Centre Hospitalier d’Agen

Abstract : Introduction: atrial fibrillation is the most common arythmia inducing serious embolic complications. This embolic risk can be controlled by anticoagulants but there is an underuse in the elderly. The objective is to determine the prevalence of VKA / DOACs in atrial fibrillation patients. The secondary objectives are to determine the characteristics of atrial fibrillation patients not receiving treatment and to determine the factors associated with the prescription of VKA / DOACs in patients with atrial fibrillation. Methods: monocentric, observational, retrospective study including subjects over 75 years old, in atrial fibrillation, anticoagulated or not, hospitalized during the year 2016, at the Agen hospital center, in geriatric short-stay service. Results: 275 patients were included, mean age of 88.7 years ± 5.25 years. 178 patients (64.5%) had anticoagulant therapy. The factor associated with the prescription of VKA / DOACs, in multivariate regression analysis, was polymedication [OR 2.95 Ic95% (1.420-34.00), p: 0.02]. Haemorrhagic antecedents [OR 0.147 Ic95% (0.331-0.656), p: 0.01] were significantly associated with non-prescription of VKA / DOACs. Age, level of dependence, cognitive impairment and risk of falling are not associated with non-prescription of anticoagulants. Conclusion: the prevalence of anticoagulants, in the elderly in atrial fibrillation, seems to be increasing even if it remains suboptimal given the significant embolic risk. The fear of an undesirable hemorrhagic event slows the prescription. Therapeutic education of patients and their caregivers, continuing medical education and real-life studies will optimize the effectiveness of anticoagulation in subjects over 75 years of age.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02496143
Contributor : Bu Carreire Université de Bordeaux <>
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Caroline Bocquée. Fibrillation auriculaire non valvulaire et traitement anticoagulant chez les personnes âgées de 75 ans et plus hospitalisées en court séjour gériatrique du Centre Hospitalier d’Agen. Médecine humaine et pathologie. 2019. ⟨dumas-02496143⟩

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