The role of pre-surgical INR testing in dental patients with liver diseases

Objectives: The aim of this study was to evaluate the validity of international normalized ratio (INR) in patients with liver diseases or abnormal liver function tests as related to bleeding risk in dental procedures. Materials and Methods: From July 2008 to January 2019, the INR of 187 patients with liver diseases who underwent oral surgical procedures at the Department of Oral and Maxillofacial Surgery Clinic, University of Maryland School of Dentistry was collected and compared with normal value. Patients who were taking anticoagulants were excluded from the data pool. Results: The compiled INR for the 187 patients (M/F = 122/65) with mean age of 47 years (range: 22–77) was 1.126, with a median and mode of 1.1. The standard deviation was 0.17. The range for the INR values was 0.7 (n = 1) to 1.7 (n = 1). Conclusion: In the present study, there was no significant difference between the INR of patients with liver diseases or abnormal liver function tests and normal INR value. This supports the belief that pre-operative INR testing is not a dependable marker to assess bleeding risk in patients with chronic liver diseases who are not taking Vitamin K antagonist anticoagulants.