Defective Fibrinolysis in Venous Thrombosis

Abstract

In previous studies a variety of attempts have been made to define laboratory tests which could predict patients who would develop deep vein thrombosis post-operatively. Such tests included the partial thromboplastin time, haematocrit and platelet adhesiveness. In this study patients undergoing gynaecological surgery were screened in advance with a panel of clinical measurements and laboratory tests and the development of DVT was noted using ¹²⁵I-fibrinogen leg scanning. The values for the selected variables were analysed using logistic discrimination. The factors with the greatest prediction were the euglobulin lysis time, age, varicose veins, serum FR-antigen and percentage overweight for height.

When this formula was applied to a further group of patients it allowed a ‘high risk’ group to be defined and these were given low-dose heparin with a significant reduction in the incidence of post-operative DVT.

An unexpected finding was that patients who smoked cigarettes appeared to be protected from post-operative DVT.