title: Multicenter Retrospective Study of the Risk Factors of Hemorrhage After Tooth Extraction in Patients Receiving Antiplatelet Therapy.
abstract: OBJECTIVE
  To identify the risk factors affecting hemorrhage after tooth extraction in patients receiving antiplatelet therapy, this study investigated the relation between various factors and hemorrhage events after tooth extraction.
  
  
  METHODS
  The records of 264 patients receiving antiplatelet therapy who underwent tooth extraction were retrospectively reviewed from 6 institutions belonging to the Japanese Study Group of Cooperative Dentistry with Medicine. Demographic information, hemorrhage events after tooth extraction, the presence or absence of comorbidities, antiplatelet agent, the use of preoperative antibiotics or nonsteroidal anti-inflammatory drugs, number of teeth extracted, serum creatinine level, estimated glomerular filtration rate, and alanine transaminase level were assessed. Risk factors for hemorrhage after tooth extraction were evaluated by univariate and multivariate analyses.
  
  
  RESULTS
  The study population of 264 patients consisted of 153 men and 111 women with a mean age of 73.6 years (range, 24 to 96 yr). Six hundred ninety-four teeth were extracted (mean, 2.6 ± 2.3 teeth per patient). In patients receiving antiplatelet therapy, the frequency of hemorrhage after tooth extraction, including mild and self-controlled hemorrhages, was 17.4%. Univariate analysis showed that serum creatinine level and dual antiplatelet therapy were correlated with hemorrhage after tooth extraction (P = .001 and P = .049, respectively). Only serum creatinine was identified as an independent risk factor for hemorrhage after tooth extraction in patients receiving antiplatelet therapy (P = .037).
  
  
  CONCLUSIONS
  The risk of hemorrhage after tooth extraction is increased in patients receiving dual antiplatelet therapy with or without chronic kidney disease. Local hemostatic treatments, such as at least suturing, are recommended.
authors.affiliation: Senior Assistant Professor, Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. Electronic address: syana@nagasaki-u.ac.jp.
authors.forename: Souichi
authors.initials: S
authors.lastname: Yanamoto
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Assistant Professor, Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Rokutanda
authors.affiliation: Clinical Fellow, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Komori
authors.affiliation: Chairman, Department of Oral and Maxillofacial Surgery, Kakogawa East City Hospital, Kakogawa, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tachibana
authors.affiliation: Chairman, Department of Oral and Maxillofacial Surgery, Kansai Medical University Hirakata Hospital, Hirakata, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kojima
authors.affiliation: Assistant Professor, Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Koyama
authors.affiliation: Professor, Department of Oral Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Shibuya
authors.affiliation: Professor, Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurita
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Komori
authors.affiliation: Professor, Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Umeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014081:Tooth Extraction / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D010975:Platelet Aggregation Inhibitors