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When do we need more than local compression to control intraoral haemorrhage?

대한구강악안면외과학회지 2019년 45권 6호 p.343 ~ 350
손준배 ( Sohn Jun-Bae ) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Oral and Maxillofacial Surgery

이호 ( Lee Ho ) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Oral and Maxillofacial Surgery
한윤식 ( Han Yoon-Sic ) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Oral and Maxillofacial Surgery
정다운 ( Jung Da-Un ) - SMG-SNU Boramae Medical Center Section of Dentistry
심혜영 ( Sim Hye-Young ) - SMG-SNU Boramae Medical Center Section of Dentistry
김희선 ( Kim Hee-Sun ) - SMG-SNU Boramae Medical Center Section of Dentistry
오소희 ( Oh So-Hee ) - SMG-SNU Boramae Medical Center Medical Research Collaborating Center

Abstract


Objectives: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required.

Materials and Methods: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage.

Results: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001).

Conclusion: A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.

키워드

Haemorrhage; Emergency treatment; Haemostasis; Anticoagulants; Oral surgery
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