Venous thromboembolism (VTE) is both common and a potential contributor to symptom burden in patients receiving palliative and end-of-life care. Many of the VTE treatment and prophylaxis recommendations are drawn from data of clinical trials assessing conventional VTE and cancer-associated thrombosis that excluded patients receiving specialist palliative or hospice care. In this group, the epidemiology of VTE and associated outcomes, as well as the risks and benefits of treatment in keeping with a palliative approach are of growing clinical and research interest. This narrative review summarizes current knowledge and challenges in the management of thromboembolic disease in palliative care, highlighting the complexity of decisions surrounding VTE treatment and prophylaxis.
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http://dx.doi.org/10.1016/j.thromres.2018.12.028 | DOI Listing |
Clin Breast Cancer
December 2024
Navarra University Hospital, Pamplona, Navarra, Spain. Electronic address:
Approximately one-third of patients with breast cancer have comorbidities at the time of their diagnosis. Recommendations for managing metastatic breast cancer are usually based on the results of clinical trials, which often limit patients with comorbidities. However, comorbidities greatly influence the quality of life, patient survival rate and treatment choice, particularly in older patients.
View Article and Find Full Text PDFThromb Res
January 2025
Department of Cardiovascular Diseases, Division of Vascular Medicine, MN, United States of America; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN, United States of America; Gonda Vascular Center, Mayo Clinic, Rochester, MN, United States of America. Electronic address:
PLoS One
January 2025
Department of Pharmacotherapy, University of Utah, Salt Lake City, Utah, United States of America.
Background: Venous thromboembolism (VTE) and atrial fibrillation (AF) disproportionately affect older adults, who are at increased risk of bleeding from treatment with anticoagulant therapy. The impact of bleeding on older adults' quality of life (QoL) is poorly understood due to the lack of a validated measure of their experience. This study's purpose is to describe the first evidence-based steps in developing a new condition-specific patient-reported outcome measure (PROM) for the effect of anticoagulant-related bleeding on older adults' QoL.
View Article and Find Full Text PDFR I Med J (2013)
February 2025
Division of Trauma and Surgical Critical Care, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island.
Background: Orthopedic trauma patients are at high risk for venous thromboembolic (VTE) complications. Despite this, VTE prophylaxis is often held peri-operatively out of concern for increased bleeding and associated complications. This review's purpose is to examine guidelines and studies on withholding prophylactic anticoagulation peri-operatively.
View Article and Find Full Text PDFAnesthesiology
January 2025
Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Background: Tranexamic acid is an anti-fibrinolytic agent routinely used during hip and knee joint replacement surgery to minimize bleeding. Chronic kidney disease is a common chronic health problem seen among adults requiring major arthroplasty surgery. Tranexamic acid is renally cleared and may accumulate in chronic kidney disease.
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