Key result
Direct oral anticoagulation use was associated with no bleeding complications in an oral surgery cohort, regardless of whether the drug was continued or discontinued.
Why the study?
Does the use of direct oral anticoagulants (DOACs) cause bleeding complications following dental surgeries?
Cohort (n=12)
No
Does the use of direct oral anticoagulants (DOACs) cause bleeding complications following dental surgeries?
This small retrospective study suggests that DOAC use, whether continued or interrupted, does not lead to bleeding complications during oral surgery, though documentation of interruption practices remains poor.
Answers are grounded in this paper and cite their sources.
DOAC use was associated with no bleeding in this oral surgery cohort; hypothesis-generating and should not yet change practice.
OBJECTIVE: To examine the effects of direct oral anticoagulants (DOACs) on bleeding complications following dental surgeries. SUBJECTS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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Miller et al. (2018) conducted a cohort in oral surgical procedures (n=12). Direct oral anticoagulants (DOACs) vs. DOAC discontinuation was evaluated on bleeding complications. Direct oral anticoagulation use was associated with no bleeding complications in an oral surgery cohort, regardless of whether the drug was continued or discontinued.
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