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The risk factors associated with postoperative hemorrhage after tooth extraction: a multi-center retrospective study of patients receiving oral antithrombotic therapy

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Abstract

The purpose of this study was to retrospectively investigate the multivariate relationships between specific risk factors and postoperative hemorrhage after tooth extraction in patients who were prescribed oral antithrombotic therapy. Risk factors for postoperative hemorrhage after tooth extraction were evaluated using univariate and multivariate analyses. Patient characteristics such as age and gender; the presence or absence of known comorbidities such as diabetes mellitus, hypertension, cerebral infarction, and alcohol consumption; and perioperative diarrhea were assessed. The drug used for antithrombotic therapy, preoperative blood test results, the presence or absence of preoperative antibiotics or nonsteroidal anti-inflammatory drug (NSAID) administration, the total number of extracted teeth, and the type of surgical procedures were also evaluated. We found that the preoperative administration of antibiotics (odds ratio (OR) = 2.52), an increased prothrombin time international normalized ratio (PT-INR) value (OR = 1.94), and the extraction of multiple teeth (OR = 2.10) were significantly associated with postoperative hemorrhage. There was no significant association between postoperative hemorrhage and any other demographic factors or comorbidities, including concomitant alcohol use. We demonstrated the multivariate relationship between the risk factors and postoperative hemorrhage after tooth extraction in patients receiving oral antithrombotic therapy. Surgeons should be aware of these risks and monitor the PT-INR of anticoagulated patients.

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Acknowledgements

We wish to thank the timely help given by Dr. Sayaka Komori, Dr. Satoshi Rokutanda, Prof. Yasuyuki Shibuya, Prof. Masahiro Umeda, and Prof. Hiroshi Kurita in analyzing the large number of samples and providing insightful comments and suggestions.

Funding

The authors received no funding for this study, including that of an institutional or departmental nature.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Takumi Hasegawa & Takahide Komori

  2. Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Souichi Yanamoto

  3. Department of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, Kakogawa, Japan

    Akira Tachibana

  4. Department of Dentistry and Oral Surgery, Kansai Medical University Hospital, Hirakata, Japan

    Yuka Kojima

  5. Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan

    Yoshito Koyama

  6. Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Michinori Maeda

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  1. Takumi Hasegawa
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  2. Souichi Yanamoto
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  3. Akira Tachibana
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  4. Yuka Kojima
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  7. Takahide Komori
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Japanese Study Group of Cooperative Dentistry with Medicine (JCDM)

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Correspondence to Takumi Hasegawa.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the institutional review board of Kobe University Graduate School of Medicine (Authorization number: 1748).

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Due to the retrospective nature of this study, informed consent is not required. Instead, we published the information of this study and granted the occasions of refusing to participate in this study.

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Hasegawa, T., Yanamoto, S., Tachibana, A. et al. The risk factors associated with postoperative hemorrhage after tooth extraction: a multi-center retrospective study of patients receiving oral antithrombotic therapy. Oral Maxillofac Surg 21, 397–404 (2017). https://doi.org/10.1007/s10006-017-0645-y

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  • DOI: https://doi.org/10.1007/s10006-017-0645-y

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