“THROMBOTEST” AND PROTHROMBIN TIME: A CONTROLLED CLINICAL TRIAL

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Abstract
Summary: A controlled trial was undertaken to assess the “Thrombotest” method and compare it to the Quick's one‐stage prothrombin time estimation in the patients attending the anticoagulant service of the Royal Prince Alfred Hospital. Two major groups of patients with ischæmic heart disease, and two minor groups consisting of patients with cerebrovascular insufficiency, rheumatic heart disease and venous thrombosis, were obtained according to preconstructed random allocation tables.It was found that the therapeutic range with the use of “Thrombotest” was consistently above our accepted range of the prothrombin time, and this was confirmed by assay of some of the individual coagulation factors depressed. The “Thrombotest” was found to be sensitive to factor IX depression below 10% “Thrombotest” activity, but there was no correlation between marked depression of Christmas factor and hemorrhage. A statistically significant difference in the recurrences was found in the ischæmic heart‐disease group, favouring the prothrombin time. Death rates suggested a similar advantage, but figures did not reach statistical significance.Major hæmorrhage was less frequent in the “Thrombotest” group, but total complications (recurrences and major hæmorrhages) still appeared to favour the Quick's one‐stage prothrombin time. No conclusions could be drawn in the cerebrovascular insufficiency and miscellaneous groups.Within the therapeutic range of 10% to 20% activity, the “Thrombotest” method did not appear as satisfactory as estimation of the prothrombin time in the prevention of arterial thrombosis.