ArticleJournal of clinical medicine2023
The Use of Oral Anticoagulation Is Not Independently Associated with Mortality in Frail Older Patients with Repeated Falls.
Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 4 citations in OpenAlex.
- Navigating Anticoagulation Decisions in Atrial Fibrillation and Frailty Comorbidity.Life (Basel, Switzerland) · 2026Review
- Polypharmacy and cardiovascular co-morbidity as key contributors to frailty in geriatric patients with AF - insights of the Dutch-GERAF cohort study.BMC geriatrics · 2026Observational
- Validation of the nurse directed frailty assessment tool, to identify patients at risk of emergency department visits, hospitalisation, and 1-year all-cause mortality.European geriatric medicine · 2025Article
- Opportunistic screening for atrial fibrillation among frail older patients, little effort for a high diagnostic yield. Outcomes of the Dutch-GERAF study.Age and ageing · 2025Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundParticularly in frail patients, anticoagulation may be underused because of the fear of bleeding.
objectiveTo determine whether the use of antithrombotic medication is an independent risk factor for mortality in frail elderly with repeated falls.
methodsAll patients aged 65 years or older at the Fall and Syncope Clinic were eligible. Frailty was calculated with a Frailty Index (FI) based on the accumulation of deficits model. Risks were calculated with a cox regression analysis, adjusted for age, sex, and Frailty Index.
results663 patients were included in this analysis. The median age was 80 years, 438 were women (66%), 73% had polypharmacy, and 380 patients (57%) had cognitive impairment. The mean FI was 0.23 (sd 0.09), 182 patients were moderately frail (27.5%), and 259 (39.1%) were severely frail. A total of 140 (21%) used oral anticoagulation and 223 (34%) used antiplatelet agents. A total of 196 patients (29.6%) died during follow-up. In the adjusted cox regression model, the use of neither antiplatelets nor anticoagulation was associated with mortality. A strong association was found with frailty (HR 74.0, 95% CI 13.1-417.3) and a weak association with age (HR 1.05, 95% CI 1.03-1.08). A lower risk of mortality was seen in women (HR 0.5, 95% CI 0.3-0.6).
conclusionsIn this cohort of frail older patients, there was no independent association between the use of antithrombotic medication and mortality. A strong association with mortality was found with frailty, a weak association was found with age, and a lower mortality risk was found in women. Our data indicate that the fear of bleeding or increased mortality in frail patients with an indication for oral anticoagulation may be unjustified.
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