Influence of antiplatelet medication and anticoagulation therapy after dental extractions on hospitalization: a retrospective 10-year study

Abstract Background The aim of this retrospective study was to identify high-risk dental extraction patients and the timing of postoperative hemorrhage to evaluate whether preventive hospitalization should be considered in patients on antiplatelet medication (AP) or anticoagulants. Methods Our study...

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Main Authors: Marie Sophie Katz, Rajae Benidamou, Mark Ooms, Marius Heitzer, Anna Bock, Dirk Elvers, Timm Steiner, Florian Peters, Frank Hölzle, Ali Modabber
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-024-05275-6
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author Marie Sophie Katz
Rajae Benidamou
Mark Ooms
Marius Heitzer
Anna Bock
Dirk Elvers
Timm Steiner
Florian Peters
Frank Hölzle
Ali Modabber
author_facet Marie Sophie Katz
Rajae Benidamou
Mark Ooms
Marius Heitzer
Anna Bock
Dirk Elvers
Timm Steiner
Florian Peters
Frank Hölzle
Ali Modabber
author_sort Marie Sophie Katz
collection DOAJ
description Abstract Background The aim of this retrospective study was to identify high-risk dental extraction patients and the timing of postoperative hemorrhage to evaluate whether preventive hospitalization should be considered in patients on antiplatelet medication (AP) or anticoagulants. Methods Our study included 1595 procedures; 1319 were conducted under monotherapy (Group I: AP; Group II: indirect oral anticoagulant [IAC]; Group III: direct oral anticoagulant [DOAC]) and 276 under dual therapy (Group IV: double AP; Group V: AP and IAC; Group VI: AP and DOAC). We evaluated the incidence, frequency and timing of hemorrhage, hospitalization rate, and treatment of bleeding incidents. Results The incidence of hemorrhagic events was significantly higher in the dual therapy groups compared to the monotherapy groups (p < 0.001). Comparing the procedures under monotherapy, those on DOAC (Group III) had a significantly higher risk of postoperative bleeding than Groups I and II (p < 0.001) and a higher rate of repeated bleeding episodes (p = 0.035). Regarding bleeding incidents, 44% (dual therapy) vs. 51.1% (monotherapy) occurred on the day of surgery. Conclusions The bleeding risk after dental extractions is overall low and patients were often hospitalized preventively due to their comorbidities rather than actual bleeding risk. Patients should be instructed about local compression, and surgeries should be completed in the morning to avoid emergency visits. However, patients with cardiovascular diseases and dual therapy had a higher risk of postoperative hemorrhage. Thus, hospitalization is to be considered in these cases. Trial registration The study was approved by the Ethics Committee of the Medical Faculty of RWTH Aachen (Decision Number 24-136). This was a retrospective clinical study designed to analyze postoperative bleeding and hospitalization rates after dental extractions in patients on AP or anticoagulation therapy.
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spelling doaj-art-04a4b2c24e3e46b4afb8fc739372a8242024-12-15T12:13:18ZengBMCBMC Oral Health1472-68312024-12-0124111010.1186/s12903-024-05275-6Influence of antiplatelet medication and anticoagulation therapy after dental extractions on hospitalization: a retrospective 10-year studyMarie Sophie Katz0Rajae Benidamou1Mark Ooms2Marius Heitzer3Anna Bock4Dirk Elvers5Timm Steiner6Florian Peters7Frank Hölzle8Ali Modabber9Department of Oral and Maxillofacial Surgery, University Hospital RWTH AachenDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH AachenDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH AachenDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH AachenDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH AachenDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH AachenDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH AachenDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH AachenDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH AachenDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH AachenAbstract Background The aim of this retrospective study was to identify high-risk dental extraction patients and the timing of postoperative hemorrhage to evaluate whether preventive hospitalization should be considered in patients on antiplatelet medication (AP) or anticoagulants. Methods Our study included 1595 procedures; 1319 were conducted under monotherapy (Group I: AP; Group II: indirect oral anticoagulant [IAC]; Group III: direct oral anticoagulant [DOAC]) and 276 under dual therapy (Group IV: double AP; Group V: AP and IAC; Group VI: AP and DOAC). We evaluated the incidence, frequency and timing of hemorrhage, hospitalization rate, and treatment of bleeding incidents. Results The incidence of hemorrhagic events was significantly higher in the dual therapy groups compared to the monotherapy groups (p < 0.001). Comparing the procedures under monotherapy, those on DOAC (Group III) had a significantly higher risk of postoperative bleeding than Groups I and II (p < 0.001) and a higher rate of repeated bleeding episodes (p = 0.035). Regarding bleeding incidents, 44% (dual therapy) vs. 51.1% (monotherapy) occurred on the day of surgery. Conclusions The bleeding risk after dental extractions is overall low and patients were often hospitalized preventively due to their comorbidities rather than actual bleeding risk. Patients should be instructed about local compression, and surgeries should be completed in the morning to avoid emergency visits. However, patients with cardiovascular diseases and dual therapy had a higher risk of postoperative hemorrhage. Thus, hospitalization is to be considered in these cases. Trial registration The study was approved by the Ethics Committee of the Medical Faculty of RWTH Aachen (Decision Number 24-136). This was a retrospective clinical study designed to analyze postoperative bleeding and hospitalization rates after dental extractions in patients on AP or anticoagulation therapy.https://doi.org/10.1186/s12903-024-05275-6Postoperative bleedingAntiplatelet therapyOral anticoagulationDental extractionHospitalizationRisk patients
spellingShingle Marie Sophie Katz
Rajae Benidamou
Mark Ooms
Marius Heitzer
Anna Bock
Dirk Elvers
Timm Steiner
Florian Peters
Frank Hölzle
Ali Modabber
Influence of antiplatelet medication and anticoagulation therapy after dental extractions on hospitalization: a retrospective 10-year study
BMC Oral Health
Postoperative bleeding
Antiplatelet therapy
Oral anticoagulation
Dental extraction
Hospitalization
Risk patients
title Influence of antiplatelet medication and anticoagulation therapy after dental extractions on hospitalization: a retrospective 10-year study
title_full Influence of antiplatelet medication and anticoagulation therapy after dental extractions on hospitalization: a retrospective 10-year study
title_fullStr Influence of antiplatelet medication and anticoagulation therapy after dental extractions on hospitalization: a retrospective 10-year study
title_full_unstemmed Influence of antiplatelet medication and anticoagulation therapy after dental extractions on hospitalization: a retrospective 10-year study
title_short Influence of antiplatelet medication and anticoagulation therapy after dental extractions on hospitalization: a retrospective 10-year study
title_sort influence of antiplatelet medication and anticoagulation therapy after dental extractions on hospitalization a retrospective 10 year study
topic Postoperative bleeding
Antiplatelet therapy
Oral anticoagulation
Dental extraction
Hospitalization
Risk patients
url https://doi.org/10.1186/s12903-024-05275-6
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