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Clinical Oral Investigations

Published in:

01-04-2021 | Dabigatran | Original Article

Postoperative bleeding after dental extraction among elderly patients under anticoagulant therapy

Authors: Masanao Inokoshi, Kazumasa Kubota, Eijiro Yamaga, Kaori Ueda, Shunsuke Minakuchi

Published in: Clinical Oral Investigations | Issue 4/2021

Abstract

Objectives

This study aimed to assess and compare postoperative bleeding occurrence after dental extraction in medically compromised elderly patients under anticoagulant therapy.

Materials and methods

This retrospective study included medically compromised elderly patients aged ≥ 65 years who were taking apixaban, dabigatran, edoxaban, rivaroxaban, or warfarin and had undergone single or multiple dental extractions. The primary outcome measure was postoperative bleeding occurrence, which was defined as oozing or marked hemorrhage from 24 h to 7 days after dental extraction. Postoperative bleeding occurrence was calculated for each anticoagulant and compared using Fisher’s exact test, followed by multiple comparisons.

Results

Two hundred thirty-two patients met the inclusion criteria. The highest postoperative bleeding occurrence was recorded for rivaroxaban (12/37: 32.4%), followed by apixaban (8/44: 18.2%), warfarin (17/98: 17.3%), and edoxaban (2/35: 5.7%). Patients taking dabigatran did not present postoperative bleeding (0/18: 0%). Fisher’s exact test, followed by multiple comparison tests, revealed a significant among-anticoagulant difference (p = 0.0095). Postoperative bleeding was significantly higher in patients taking rivaroxaban than in those taking edoxaban or dabigatran (p = 0.03088).

Conclusions

Within the limitations of this retrospective study design, these findings suggest that different anticoagulants may affect postoperative bleeding occurrence after dental extraction among medically compromised elderly patients.

Clinical relevance

Clinicians should carefully consider postoperative bleeding after dental extraction in patients taking anticoagulant therapy, especially rivaroxaban.

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Title: Postoperative bleeding after dental extraction among elderly patients under anticoagulant therapy
Authors: Masanao Inokoshi
Kazumasa Kubota
Eijiro Yamaga
Kaori Ueda
Shunsuke Minakuchi
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Keywords: Dabigatran
Carvedilol
Edoxaban
Anticoagulant
Direct Oral Anticoagulant
Amlodipine
Atrial Fibrillation
Apixaban
Warfarin
Direct Oral Anticoagulant
Rivaroxaban
Published in: Clinical Oral Investigations / Issue 4/2021
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-020-03559-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Postoperative bleeding after dental extraction among elderly patients under anticoagulant therapy

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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