Paliatívna medicína a liečba bolesti 2e/2019

Do thromboprophylaxis and anticoagulant therapy has any relevance in hospice?

Hospice patients have a high risk of venous thromboembolism, which in most cases is asymptomatic and does not impair their quality of life. On the other hand, hospice patients are at risk of haemorrhagic complications when receiving anticoagulant therapy. Studies suggest that primary thromboprophylaxis has little relevance to hospice patients. Since maintaining the highest possible quality of the last days of life in a hospice is one of the highest priorities, anticoagulant therapy can, on the one hand, benefit the hospice patient by eliminating the unpleasant symptoms of clinically manifest thromboembolism, and on the other hand, can cause discomfort. Intracranial haemorrhage is a feared and serious complication of anticoagulant therapy in patients with brain tumours. While the studies in brain metastases have not shown an increased risk of intracranial haemorrhage associated with anticoagulant administration, in primary brain tumours such as glioma, the risk of intracranial haemorrhage was up to threefold increased. Key words: hospice patient, thromboembolism, anticoagulant therapy, quality of life, intracranial haemorrhage

Keywords: hospice patient, thromboembolism, anticoagulant therapy, quality of life, intracranial haemorrhage