{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T13:24:55Z","timestamp":1794317095736,"version":"4.9.0"},"reference-count":67,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>With improvements in medical care, the life expectancy of patients with bleeding disorders is approaching that of the general population. A growing population of older adult patients with bleeding disorders is at risk of age-related comorbidities and in need of various elective and emergent age-related procedures. The increased risk of thrombosis and volume overload in older adults complicates perioperative hemostatic management. Furthermore, antithrombotic treatment such as antiplatelet or anticoagulant therapy, which is frequently required for various cardiovascular interventions, requires a meticulous individualized approach. Evidence-based guidelines for the management of aging patients with bleeding disorders are lacking, largely due to the underrepresentation of older adult patients in clinical trials as well as the rarity of many such bleeding disorders. We discuss the current guidelines and recommendations in the perioperative hemostatic management of older adult patients with hemophilia and von Willebrand disease as well as other rare bleeding disorders. The optimal management of these patients is often complex and requires a thorough multidisciplinary and individualized approach involving hematologists, surgeons, anesthesiologists, and the specialists treating the underlying disorder.<\/jats:p>","DOI":"10.1182\/hematology.2021000288","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T12:17:57Z","timestamp":1639138677000},"page":"529-535","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":7,"title":["How to manage bleeding disorders in aging patients needing surgery"],"prefix":"10.1182","volume":"2021","author":[{"given":"Mouhamed Yazan","family":"Abou-Ismail","sequence":"first","affiliation":[{"name":"Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, University of Utah, Salt Lake City, UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan T.","family":"Connell","sequence":"additional","affiliation":[{"name":"Hematology Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"issue":"3","key":"2021121012082180300_hem2021000288C1","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/jth.15182","article-title":"Mortality, life expectancy, and causes of death of persons with hemophilia in the Netherlands 2001-2018","volume":"19","author":"Hassan","year":"2021","journal-title":"J Thromb Haemost"},{"issue":"26","key":"2021121012082180300_hem2021000288C2","doi-asserted-by":"crossref","first-page":"5256","DOI":"10.1182\/blood-2009-07-215665","article-title":"How I treat age-related morbidities in elderly persons with 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