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J Craniomaxillofac Surg ; 52(6): 772-777, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38580558

RESUMO

The aim of this study was to evaluate whether direct oral anticoagulants (DOAC) and vitamin K antagonists (VKA) increase the risk of postoperative bleeding after dentoalveolar surgery. Patients were classified into two groups: one taking DOAC and the other taking VKA with a therapeutic INR range. The control group comprised non-anticoagulated subjects. Participants were matched regarding dentoalveolar procedure. The primary predictor was anticoagulant status. The primary outcome was postoperative bleeding. The DOAC group comprised 77 patients, while the VKA group and control group each consisted of 103 participants. In each group, 103 dentoalveolar surgical procedures were conducted. Postoperative bleeding was recorded in 3/103 (2.9%), 5/103 (4.8%), and 1/103 (0.97%) occasions in the DOAC, VKA, and control groups, respectively, without significant difference (χ2; p = 0.54). The fully adjusted odds ratio for postoperative bleeding was 0.14 (CI 0.01-1.61; p = 0.05) for patients taking DOAC and 0.19 (CI 0.02-1.65; p = 0.285) for those taking VKA compared with non-anticoagulated controls. In conclusion, there was no increase in risk for clinically significant postoperative bleeding after dentoalveolar surgery in patients taking DOAC or VKA compared with non-anticoagulated subjects. Dentoalveolar surgery in patients taking DOAC and VKA can be performed safely without therapy cessation. The study was registered at Clinicaltrials.gov (NCT04505475).


Assuntos
Anticoagulantes , Procedimentos Cirúrgicos Bucais , Hemorragia Pós-Operatória , Vitamina K , Humanos , Hemorragia Pós-Operatória/induzido quimicamente , Vitamina K/antagonistas & inibidores , Anticoagulantes/uso terapêutico , Masculino , Feminino , Estudos Prospectivos , Idoso , Pessoa de Meia-Idade , Administração Oral , Fatores de Risco , Idoso de 80 Anos ou mais
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