Evaluation of Hemorrhage Immediately after Extraction and Postextraction in Patients on Oral Anticoagulant Therapy for Last 5 Years

Abstract

Aim and Objective: The aim of our study was to evaluate hemorrhage immediately after extraction and postextraction in patients on oral anticoagulant therapy for the past 5 years. Materials and Methods: A total of 100 patients, equally divided into study group and control group of 50 patients each, who were on anticoagulant therapy for the past 5 years were included in the study and were assessed for general medical status, drug dosage, indication for anticoagulant therapy, and duration of treatment before being included in the study. Before undertaking any procedure, the international normalized ratio (INR) for each of the patient under study was requested and the study was only performed if INR was within the therapeutic range of 2.0–4.0 for each patient. Any patients with INR outside the therapeutic range, patients with liver disease, patients on other drugs that affect the hemostasis (long-term use of nonsteroidal anti-inflammatory drug, chemotherapeutic and immunosuppressant drugs), and patients who refused to sign the consent for the study were excluded from the study. Results: None of the patients, in study group, had any immediate postoperative bleeding during the 30 min that they were observed after the extractions, and no patient in study group had any bleeding during the first 24 h. One patient from the study group (50-year-old female, INR 3.2) had intermittent oozing on the 3rd day postoperatively, after extractions of lower right 2nd molar. Conclusion: We conclude that hemorrhagic episodes postextraction in patients on anti-coagulant therapy is manageable following atraumatic extraction, hemostatic agents and sutures. Its also concluded that patients on anticoagulant are at high risk of thromboembolic events than postextraction hemorrhage so anticoagulant therapy should be continued without any alteration.