Department of Oral Health Practice, Division of Oral Medicine, Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.
Oral Dis. 2018 Mar;24(1-2):243-248. doi: 10.1111/odi.12698.
To examine the effects of direct oral anticoagulants (DOACs) on bleeding complications following dental surgeries.
This 6-year retrospective study collected data from records of patients undergoing oral surgical procedures within a university setting. An electronic health record database was searched using current procedural terminology codes for oral surgical procedures. Information regarding patient, procedural factors, and postoperative complications were extracted. Data were analyzed by Fisher's exact test.
Of patients who had a procedural code associated with oral surgery, only 0.11% (12/11,320) took a DOAC. Twelve patients (10 males, age ranging from 44 to 90 years) underwent 17 surgeries by nine different practitioners involving 98 extractions, 14 alveoloplasties, two tuberosity reductions, and two tori removals. In nine cases, the DOAC was discontinued a mean of 52.5 hrs prior to surgery (range 12-120 hrs). Bleeding complications were not reported for patients whose drug was discontinued or continued. Documentation of drug continuation/discontinuation was poor.
Bleeding was not observed with direct oral anticoagulation use in this oral surgery cohort. Drug discontinuation/continuation was not a factor in bleeding outcomes, and direct oral anticoagulation interruption was variable and poorly documented.
研究直接口服抗凝剂（DOACs）对牙科手术后出血并发症的影响。
这是一项为期 6 年的回顾性研究，从一所大学口腔手术记录中收集数据。使用当前手术程序术语代码对口腔手术程序的电子健康记录数据库进行了搜索。提取了有关患者、程序因素和术后并发症的信息。通过 Fisher 精确检验进行数据分析。
在接受口腔手术的患者中，只有 0.11%（12/11320）服用了 DOAC。12 名患者（10 名男性，年龄 44 岁至 90 岁）由 9 名不同的医生进行了 17 次手术，涉及 98 次拔牙、14 次牙槽成形术、2 次结节切除术和 2 次切牙切除术。在 9 例中，DOAC 在手术前平均停用 52.5 小时（范围 12-120 小时）。停药或继续用药的患者均未报告出血并发症。药物继续/停止使用的记录很差。
在本口腔手术队列中，使用直接口服抗凝剂未观察到出血。停药/继续用药不是出血结局的因素，直接口服抗凝剂中断时间不同且记录不佳。
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