Modified Child-Pugh score as a marker for postoperative bleeding from invasive dental procedures.
OBJECTIVE
The objective of this study was to determine if the modified Child-Pugh score (MCP) is associated with peri- and postoperative bleeding complications from invasive dental procedures in patients with advanced liver disease.


METHODS
Patients with advanced liver disease who underwent an invasive dental procedure were identified retrospectively. The following information was collected for each patient: demographics, the MCP values (albumin, bilirubin, prothrombin time [PT], ascites, and encephalopathy), platelet count, adjunctive postoperative procedures (APPs) (e.g., administration of replacement blood products) following invasive dental procedures, and peri- and postoperative bleeding complications. The primary outcome was the need for APP to manage postoperative bleeding.


RESULTS
Fifty-two patients met the inclusion criteria. Thirteen (25%) patients required one or more APP to control postoperative bleeding. The MCP score, bilirubin, and PT were higher, and the platelet count was lower in the APP group. Ascites was more common in the APP group.


CONCLUSIONS
In addition to traditionally used parameters of bleeding in advanced liver disease, the MCP was found to be associated with postoperative bleeding complications in this patient population.
Valerin
Manuel A
MA
Carolina Medical Center, Charlotte, NC, USA. m.valerin@insightbb.com <m.valerin@insightbb.com>
Napeñas
Joel J
JJ
Brennan
Michael T
MT
Fox
Philip C
PC
Lockhart
Peter B
PB
D001201:Ascites / Q000150:complications; D015331:Cohort Studies; D017742:Dental Care for Chronically Ill / Q000379:methods*; D005260:Female; D005544:Forecasting / Q000379:methods*; D006801:Humans; D008107:Liver Diseases / Q000145:classification* / Q000150:complications; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D018709:Statistics, Nonparametric; D014081:Tooth Extraction / Q000009:adverse effects*