Hemorrhagic complications in individuals with liver disease submitted to minor oral surgery.

Autor: Souza AF; Department of Oral Surgery and Pathology., Rocha AL; Department of Oral Surgery and Pathology., Silva RKM; Department of Oral Surgery and Pathology., Bemquerer LM; Department of Oral Surgery and Pathology., Lanza CRM; Department of Oral Surgery and Pathology., Castro WH; Department of Oral Surgery and Pathology., Abreu LG; Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil., Silva TA; Department of Oral Surgery and Pathology., Travassos DV; Department of Community and Preventive Dentistry.
Jazyk: angličtina
Zdroj: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis [Blood Coagul Fibrinolysis] 2022 Oct 01; Vol. 33 (7), pp. 412-417. Date of Electronic Publication: 2022 Jul 22.
DOI: 10.1097/MBC.0000000000001157
Abstrakt: Individuals with chronic liver disease (CLD) have an increased risk of bleeding from thrombocytopenia and changes in hemostasis. The aim of this study was to evaluate the frequency of and the factors associated with the occurrence of bleeding in CLD patients who underwent dental surgical procedures. This was a retrospective study whose data were collected in a hospital dentistry service between 2010 and 2016. The patients were referred from the gastroenterology and liver transplantation services of a university hospital for dental treatment. The study followed the STROBE guidelines. Among the 71 surgical procedures performed, there were 17 (24%) perioperative and postoperative bleeding episodes, 14 of which were in pretransplant patients and 11 received blood transfusion before dental surgery. Individuals with a previous history of bleeding (PR = 2.67, CI = 1.07-6.67, P  = 0.035) and those with a platelet count before surgery 50 × 10 9 /l or less (PR = 7.48, CI = 1.70-32.86, P  = 0.008) had a higher prevalence of perioperative and postoperative bleeding episodes than their peers without a previous history of bleeding, and those with platelet count greater than 50 × 10 9 /l. The approach to individuals with CLD is complex and represents a challenge to the clinician. A careful anamnesis combined with laboratory screening of coagulation disorders appears to be useful to identify individuals at a major risk of bleeding. Studies identifying the predisposing factors of bleeding in CLD patients support well tolerated protocols for oral surgery in this group.
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Databáze: MEDLINE