THE USE OF DICUMAROL AS AN ANTICOAGULANT: EXPERIENCE IN 2,307 CASES

Abstract

The expert use of the anticoagulants, heparin, and dicumarol, has improved tremendously the outlook for patients who have acute vascular thrombosis. An over-all consideration of 1,513 postoperative patients treated With anticoagulants indicates that the following results were achieved: 85 patients survived who would have been expected to die from pulmonary embolism; 250 patients were spared venous thrombosis or nonfatal pulmonary embolism. In 506 additional postoperative cases in which dicumarol was used prophylactically, venous thrombosis occurred in but 2 instances; there was no pulmonary embolism. A consideration of 288 medical patients indicates that fatal pulmonary embolism was prevented by anticoagulants. Nonfatal pulmonary embolism and venous thrombosis occurred very infrequently. A study of 50 cases of acute myocardial infarction indicates substantial reduction in the incidence of further myocardial infarction and in arterial embolism and venous thrombosis. Survival of the extremity occurred in 91% of cases of arterial embolism and in 81% of cases of arterial thrombosis, if treatment with anticoagulants was begun early and supplemented by other treatment. In general, the use of anticoagulants constitutes the greatest contribution to the successful treatment and prevention of intravascular thrombosis and embolism.