The Prediction of Thromboembolism

The great necessity for some laboratory aid in the diagnosis or prediction of thromboembolic disease has led to the extensive investigation of clotting here reported. As yet, no test of sufhcient specificity, reliability, and reproducibility has arisen. It is by no means established that the general state of fluidity of the blood is more important than local factors in the genesis of bland thrombi, nor has the extent of participation of the vein wall been defined. On the positive side, a high incidence of thromboembolic complications may be anticipated in the patients exposed to bed rest, operation, or trauma, who have had previous thromboembolism, who have cardiovascular disease, particularly with congestive failure or who are debilitated, or anemic. The tests of the speed of clot retraction and of the presence of fibrinogen B are promising aids, but need much more extensive evaluation by a variety of investigators.