PB1001 - Anticoagulation for Venous Thromboembolism (VTE) in patients aged >80 years: a focus on bleeding

Background: Anticoagulation for VTE treatment in patients ≥80 years can be challenging due to the perceived increased risk of bleeding. Little published outcome data exists in this cohort of patients. With a growing worldwide older adult population, its important to understand the risks with anticoagulant use.

Aims: To report on bleeding outcomes of patients > 80 years diagnosed with VTE.

Methods: We retrospectively evaluated the records of all patients >80 years of age, diagnosed with acute VTE between January 2021 and July 2023 at the Princess Royal University Hospital, UK. Data included cancer diagnosis, concomitant medications and any recorded bleeding following the commencement of anticoagulation, classified according to ISTH definitions. Descriptive statistics were used to report findings.

Results: During the observation period, 502 patients met the inclusion criteria and had their records reviewed. Demographic information on these patients is presented in Table 1.
102 (20.7%) patients experienced bleeding of any severity. Major bleeding was observed in 9 patients (1.8%) of which 5 patients had active cancer. Three patients had hemoptysis (all 3 had lung cancer), 3 had gastrointestinal bleeding (1 had gastrointestinal cancer, 1 had multiple myeloma), 3 had CNS bleeding (1 had primary CNS tumor and 1 had CNS metastasis of lung cancer). No clinically relevant non major bleeding episodes were observed and the majority of the bleeding episodes occured within 3 months of commencing anticoagulation (91 patients, 87.5% of bleeding episodes).
Factors associated with bleeding, included cancer and are outlined in Table 2.

Conclusion(s): Our experience suggests that anticoagulation for patients >80 years is relatively safe without an overt increase in major bleeding. Cancer is associated with major bleeding events and in patients with the presence of polypharmacy. Further outcome data is needed, particularly in patients >90 years of age.