Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication
Abstract Background The aim of this study was to investigate the occurrence of postoperative bleeding following dentoalveolar surgery in patients with either continued vitamin K antagonist medication or perioperative bridging using heparin. Methods A retrospective study was performed analyzing patie...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Oral Health |
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| Online Access: | https://doi.org/10.1186/s12903-021-01464-9 |
| _version_ | 1831672387755573248 |
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| author | Mayte Buchbender Felix Rößler Marco R. Kesting Gesche Frohwitter Werner Adler Andrea Rau |
| author_facet | Mayte Buchbender Felix Rößler Marco R. Kesting Gesche Frohwitter Werner Adler Andrea Rau |
| author_sort | Mayte Buchbender |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to investigate the occurrence of postoperative bleeding following dentoalveolar surgery in patients with either continued vitamin K antagonist medication or perioperative bridging using heparin. Methods A retrospective study was performed analyzing patients who underwent tooth extraction between 2012 and 2017. Patients were retrospectively allocated into two comparative groups: un-paused vitamin K antagonist medication versus bridging using heparin. A healthy, non-anticoagulated cohort with equivalent surgery served as a control group. Main outcome measures were: the occurrence and frequency of postoperative bleeding, the number of removed teeth, the surgical technique of tooth removal (extraction/osteotomy/combined extraction and osteotomy) and the prothrombin time. Results In total, 475 patients were included in the study with 170 patients in the group of un-paused vitamin K antagonist medication VG, 135 patients in the Bridging group BG and 170 patients in the control group CG. Postoperative bleeding was significant: CG versus VG p = 0.004; CG versus BG p < 0.001, BG versus VG p < 0.001. A significant correlation of number of the extracted teeth in the BG (p = 0.014) and no significance in VG (p = 0.298) and CG (p = 0.210) and in the BG versus VG and CG with p < 0.001 in terms of surgical intervention extraction. No difference observed in terms of prothrombin time. Conclusions Bridging with heparin increases the risk for bleeding compared to un-paused vitamin K antagonist medication. The perioperative management of anticoagulated patients requires a well-coordinated interdisciplinary teamwork to minimize or at best avoid both: postoperative bleeding and thromboembolic incidences. |
| first_indexed | 2024-12-19T23:52:14Z |
| format | Article |
| id | doaj.art-4fb97a4ec5354de1bda46061c02cec15 |
| institution | Directory Open Access Journal |
| issn | 1472-6831 |
| language | English |
| last_indexed | 2024-12-19T23:52:14Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Oral Health |
| spelling | doaj.art-4fb97a4ec5354de1bda46061c02cec152022-12-21T20:01:06ZengBMCBMC Oral Health1472-68312021-03-012111810.1186/s12903-021-01464-9Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medicationMayte Buchbender0Felix Rößler1Marco R. Kesting2Gesche Frohwitter3Werner Adler4Andrea Rau5Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-NurembergDepartment of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-NurembergDepartment of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-NurembergDepartment of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-NurembergDepartment of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen-NurembergDepartment of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-NurembergAbstract Background The aim of this study was to investigate the occurrence of postoperative bleeding following dentoalveolar surgery in patients with either continued vitamin K antagonist medication or perioperative bridging using heparin. Methods A retrospective study was performed analyzing patients who underwent tooth extraction between 2012 and 2017. Patients were retrospectively allocated into two comparative groups: un-paused vitamin K antagonist medication versus bridging using heparin. A healthy, non-anticoagulated cohort with equivalent surgery served as a control group. Main outcome measures were: the occurrence and frequency of postoperative bleeding, the number of removed teeth, the surgical technique of tooth removal (extraction/osteotomy/combined extraction and osteotomy) and the prothrombin time. Results In total, 475 patients were included in the study with 170 patients in the group of un-paused vitamin K antagonist medication VG, 135 patients in the Bridging group BG and 170 patients in the control group CG. Postoperative bleeding was significant: CG versus VG p = 0.004; CG versus BG p < 0.001, BG versus VG p < 0.001. A significant correlation of number of the extracted teeth in the BG (p = 0.014) and no significance in VG (p = 0.298) and CG (p = 0.210) and in the BG versus VG and CG with p < 0.001 in terms of surgical intervention extraction. No difference observed in terms of prothrombin time. Conclusions Bridging with heparin increases the risk for bleeding compared to un-paused vitamin K antagonist medication. The perioperative management of anticoagulated patients requires a well-coordinated interdisciplinary teamwork to minimize or at best avoid both: postoperative bleeding and thromboembolic incidences.https://doi.org/10.1186/s12903-021-01464-9Anticoagulation therapyBleedingBridging with heparinVitamin K antagonist |
| spellingShingle | Mayte Buchbender Felix Rößler Marco R. Kesting Gesche Frohwitter Werner Adler Andrea Rau Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication BMC Oral Health Anticoagulation therapy Bleeding Bridging with heparin Vitamin K antagonist |
| title | Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication |
| title_full | Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication |
| title_fullStr | Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication |
| title_full_unstemmed | Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication |
| title_short | Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication |
| title_sort | management of anticoagulated patients in dentoalveolar surgery a retrospective study comparing bridging with heparin versus unpaused vitamin k antagonist medication |
| topic | Anticoagulation therapy Bleeding Bridging with heparin Vitamin K antagonist |
| url | https://doi.org/10.1186/s12903-021-01464-9 |
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