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Effect of warfarin discontinuation on the incidence of postoperative bleeding in tooth extraction

대한구강악안면외과학회지 2020년 46권 4호 p.228 ~ 234
이정수, 김문기, 강상훈,
소속 상세정보
이정수 ( Lee Jung-Soo ) - National Health Insurance Service Ilsan Hospital Department of Oral and Maxillofacial Surgery
김문기 ( Kim Moon-Key ) - National Health Insurance Service Ilsan Hospital Department of Oral and Maxillofacial Surgery
강상훈 ( Kang Sang-Hoon ) - National Health Insurance Service Ilsan Hospital Department of Oral and Maxillofacial Surgery

Abstract


Objectives: The number of patients undergoing oral anticoagulant therapy for cardiovascular and cerebrovascular disease is increasing. However, the risk of bleeding after tooth extraction in patients receiving warfarin is unclear. Here, we assess the risk of bleeding after tooth extraction in patients on warfarin.

Materials and Methods: The study included 260 patients taking warfarin who underwent tooth extraction (694 teeth). The patients were divided into those whose teeth were extracted while they were taking warfarin, those who discontinued warfarin before extraction, and those who underwent extrac-tion while receiving heparin bridging therapy. Bleeding complications in the two groups were compared.

Results: Of the 260 patients, 156 underwent extraction while taking warfarin, 70 stopped taking warfarin before extractions, and 34 received heparin bridging therapy and stopped taking either medication before extractions. Bleeding complications occurred in 9 patients (3.5%) and 9 tooth sites (1.3%). Among the 9 patients with bleeding complications, 6 underwent extraction while taking warfarin, 2 stopped warfarin before extraction, and 1 under-went extraction after receiving heparin bridging therapy. No significant difference was seen between patient groups regarding bleeding after extractions (P=0.917).
Conclusion: Warfarin use does not increase the risk of post-extraction bleeding and can therefore be continued during tooth extraction.

키워드

Bleeding; Tooth extraction; Warfarin

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