| Objective:As a new generation of anticoagulant,rivaroxaban has been widely used in basic hospital for its convient,curative effect,increased indications.Current studies on rivaroxaban at home and abroad are more focused on the population of all age groups less on elderly patients.For the special physiological structure of elderly patients and some current studies have shown that the risk of bleeding for elderly patients after oral anticoagulant therapy is increased.So we carry out this study to investigate the real clinical results and safety for elderly patients after oral anticoagulant therapy.Method:This study is a retrospective research.This article is a retrospective study for the elderly patients in the No.1 Hospital of Jilin University cadre ward from September2015 to December 2017 using rivaroxaban,whose age is equal or more than 65 years old.The age,sex,daily dose,the purpose of rivaroxaban treatment,the first time of bleeding and the type of bleeding were collected.The relationship between age,sex,dosage,different purpose of rivaroxaban treatment and the rate bleeding are analysed.What's more,the data are compared with the results of the domestic and foreign rivaroxaban clinical trials and analysed by statistical software SPSS22.0.P <0.05 means statistical sense.Result:608 cases of elderly patients with rivaroxaban were retrospective analysed.117 patients were excluded because of irregular use of rivaroxaban,incomplete medical history and usage of other anticoagulant besides of rivaroxaban.Among the 491 recruited patient,183 cases of male patients account for 37.3% of the total and 308 cases of male patients account for 62.7%.The average age is 76.01± 5.54 years old.The maximum age is 89 years,the minimum age is 65.Among all patients treated with rivaroxaban,the number of hemorrhage patients is 63 and the total hemorrhage rate is 12.83%.The bleeding rate of Patients who take daily dose of 5mg is 0%,while10 mg is 11.60%,15 mg is 14.11%,20 mg is 75.0%.The difference have statistical sense.(P<0.01).The incidence of bleeding in different age groups:the rate of 65-70 year old group is 6.82% as well as 71-75 group is 13.95%,76-80 group is15.15%,81-85 group is 15.31% and more than 86 group is 15.38%.The difference have no statistical sense(P>0.05).In all types of bleeding,The incidence of dermorrhagia is 5.07%,accounting for 44.44% of all types of bleeding in the meanwhile the rate of mucosa bleeding is 4.07%,accounting for 31.75% and the rate of hemorrhage of digestive tract is 3.05%,accounting for 23.81%.There is no massive haemorrhage which cause the death of patients or require blood transfusions in our survey.The first bleeding of 53.97% of the bleeding patients occured within 1 months during period of taking rivaroxaban as well first bleeding of 26.98% of the patients occured within 1-2 months 12.70%of first bleeding happened within 2-3 months and only 6.35% of first bleeding occured more than 3 months.The bleeding rates of different treatment group are different: the rate of AF group is 16.22%,the rate of PE group is 14.29%,the rate of DVT group is 6.94%,the rate of VTE group is 15.87%.The difference have statistical sense.(P<0.05).In this retrospective study,the bleeding rate of male elderly patients is 10.93%,and the rate of female elderly patients is13.96%.There was no difference in bleeding risk between male and female patients(P>0.05).Conclusion :The following is found in the larger series of investigation: 1.With the increase of daily dose,the risk of bleeding in patients taking rivaroxaban increased significantly.10 mg per day may be safety.2.The proportion of women is higher than that of men among people who take rivaroxaban.3.The first months for elderlypatients who taking rivaroxaban may be a high risk period for bleeding.4.Different purpose of rivaroxaban treatment may have different bleeding rates: the incidence of hemorrhage for AF group is the highest. |
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