Anticoagulants as a Cause of Hemorrhage

Physicians using anticoagulants must beware of the risk of hemorrhage. Major hemorrhage occurred in 1.9 per cent of 9,609 patients given dicumarol,® according to the literature. Data obtained from a questionnaire¹answered by 136 physicians experienced in the use of dicumarol® and heparin indicate that major hemorrhage occurred in 2 per cent of about 15,500 patients treated. The chief site of major hemorrhage was the urinary tract. Gross hematuria occurred in 93 cases recorded in the questionnaire, but in no instance was it the cause of death although hematuria was associated with fatal bleeding in other sites in three cases. Hematuria was not followed by residual renal impairment. Most other instances of major bleeding were associated with pathological lesions in the gastrointestinal tract or lungs or were in postoperative sites.