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Medicine: Accidents & the Elderly

2 minute read
TIME

All too often after major surgery, especially among elderly patients in accident cases, there is truth in the sour jest that the operation was a success but the patient died. Last week, in the London medical journal Lancet, two physicians described a method of treatment that slashed the death rate among such patients at Birmingham Accident Hospital in England’s Midlands.

Commonest cause of death in these cases, they found, was blocking of a pulmonary artery by a traveling blood clot that had developed in the leg veins. This often undetectable process killed 40%-50% of patients over 50, who died after fractures of the leg, thigh or pelvis. So Drs. Simon Sevitt and Nrall G. Gallagher took 300 consecutive admissions of patients over 55 with broken thighs, and treated half of them with the anticoagulant phenindione to see whether it would prevent blood clotting and the fatal lung damage.

Of 150 patients, none had a major lung-artery blockage while receiving phenindione. though three had embolisms (two of them fatal) after the drug was stopped. Among the untreated 150, no fewer than 15 deaths appeared to be solely or substantially attributable to traveling clots. Like all anticoagulants, phenindione must be given under the strictest medical supervision, usually in a hospital, with frequent laboratory tests to guard against the danger of uncontrollable bleeding, and some accidents or illnesses would preclude treatment. But with these precautions, the British method looks promising.

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