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Bleeding during and after dental extractions in patients with liver cirrhosis.
Medina, J B; Andrade, N S; de Paula Eduardo, F; Bezinelli, L; Franco, J B; Gallottini, M; Braz-Silva, P H; Ortega, K L.
Afiliação
  • Medina JB; Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil; Division of Dentistry, Mario Covas State Hospital of Santo André, São Paulo, Brazil.
  • Andrade NS; Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
  • de Paula Eduardo F; Albert Einstein Hospital, São Paulo, Brazil.
  • Bezinelli L; Albert Einstein Hospital, São Paulo, Brazil.
  • Franco JB; Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil.
  • Gallottini M; Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
  • Braz-Silva PH; Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil; Laboratory of Virology, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil.
  • Ortega KL; Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil. Electronic address: klortega@usp.br.
Int J Oral Maxillofac Surg ; 47(12): 1543-1549, 2018 Dec.
Article em En | MEDLINE | ID: mdl-29705406
Little is known about the prevention and management of acquired coagulopathies, such as those affecting cirrhotic patients. The objective of this analytic retrospective observational study was to evaluate patients on the liver transplant waiting list according to the following outcomes: (1) presence of unusual intraoperative bleeding (>10min after routine haemostatic procedures); and (2) presence of postoperative haemorrhagic complications. The outcomes were analysed according to clinical and laboratory variables. A total of 190 visits were performed for extraction of 333 teeth (ranging from 1 to 9 teeth per visit), with platelet count ranging from 16,000 to 216,000 and international normalized ratio (INR) below 3. Twelve cases (6.31%) had unusual intraoperative bleeding and 12 had postoperative haemorrhagic complications. All the events were controlled by local measures. Intraoperative bleeding was associated with low count of platelets (P=0.026). However, this counting could explain only 16% (adjusted R2=0.16) of the cases of bleeding (P=0.44), meaning that platelet function changes might be involved. Our results show that cirrhotic patients presenting platelet count above 16,000 and INR below 3 need no previous blood transfusion, with local measures being enough to manage haemorrhagic events.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Extração Dentária / Hemorragia Pós-Operatória / Cirrose Hepática Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Int J Oral Maxillofac Surg Assunto da revista: ODONTOLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Dinamarca
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Extração Dentária / Hemorragia Pós-Operatória / Cirrose Hepática Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Int J Oral Maxillofac Surg Assunto da revista: ODONTOLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Dinamarca