Key result
High-risk patients continuing aspirin therapy during minor oral surgery had a 4.5 times higher risk of immediate bleeding compared to non-users (RR 4.5), though all events were easily controlled.
Why the study?
Does uninterrupted aspirin therapy increase the risk of bleeding in patients undergoing minor oral surgical procedures?
Cohort (n=2,912)
No
Does uninterrupted aspirin therapy increase the risk of bleeding in patients undergoing minor oral surgical procedures?
Continuing aspirin therapy during minor oral surgery increases the risk of bleeding, but the bleeding is easily managed with simple hemostatic measures, supporting the continuation of aspirin to avoid serious cardiovascular complications.
Answers are grounded in this paper and cite their sources.
Uninterrupted aspirin was associated with higher bleeding risk; leaves open whether continuation remains appropriate in high-risk patients pending prospective trials.
OBJECTIVES: This study aimed to estimate the risk of bleeding following minor oral surgical procedures and uninterrupted aspirin therapy in high-risk patients or patients with existing chronic diseases compared to patients who did not use aspirin during minor oral surgery at a public hospital. METHODS: This retrospective cohort study analyzed the data of 2912 patients, aged 20 years or older, who underwent 5251 minor oral surgical procedures at a district hospital in Thailand. The aspirin group was comprised of patients continuing aspirin therapy during oral surgery. The non-aspirin group (reference) included all those who did not use aspirin during surgery. Immediate and late-onset bleeding was evaluated in each procedure. The risk ratio of bleeding was estimated using a multilevel Poisson regression. RESULTS: The overall cumulative incidence of immediate bleeding was 1.3% of total procedures. No late-onset bleeding was found. A significantly greater incidence of bleeding was found in the aspirin group (5.8% of procedures, p<0.001). After adjusting for covariates, a multilevel Poisson regression model estimated that the bleeding risk in the aspirin group was 4.5 times higher than that of the non-aspirin group (95% confidence interval, 2.0 to 10.0; p<0.001). However, all bleeding events were controlled by simple hemostatic measures. CONCLUSIONS: High-risk patients or patients with existing chronic diseases who continued aspirin therapy following minor oral surgery were at a higher risk of hemorrhage than general patients who had not used aspirin. Nonetheless, bleeding complications were not life-threatening and could be promptly managed by simple hemostatic measures. The procedures could therefore be provided with an awareness of increased bleeding risk, prepared hemostatic measures, and postoperative monitoring, without the need for discontinuing aspirin, which could lead to more serious complications.
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Rojanaworarit et al. (2017) conducted a cohort in Minor oral surgical procedures (n=2,912). Uninterrupted aspirin therapy vs. Non-aspirin group was evaluated on Immediate bleeding (excessive blood that could not be controlled by gauze packing within 30 minutes postoperatively) (RR 4.5, 95% CI 2.0 to 10.0, p=<0.001). High-risk patients continuing aspirin therapy during minor oral surgery had a 4.5 times higher risk of immediate bleeding compared to non-users (RR 4.5), though all events were easily controlled.
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