When do we need more than local compression to control intraoral haemorrhage?
10.5125/jkaoms.2019.45.6.343
- Author:
Jun Bae SOHN
1
;
Ho LEE
;
Yoon Sic HAN
;
Da Un JUNG
;
Hye Young SIM
;
Hee Sun KIM
;
Sohee OH
Author Information
1. Department of Oral and Maxillofacial Surgery, Seoul Metropolitan Government-Seoul National University (SMG-SNU) Boramae Medical Center, Seoul, Korea. neo0224@gmail.com
- Publication Type:Original Article
- Keywords:
Haemorrhage;
Emergency treatment;
Haemostasis;
Anticoagulants;
Oral surgery
- MeSH:
Anticoagulants;
Electrocoagulation;
Emergency Service, Hospital;
Emergency Treatment;
Fibrinolytic Agents;
Gingiva;
Hemorrhage;
Humans;
Liver Cirrhosis;
Male;
Methods;
Odds Ratio;
Retrospective Studies;
Risk Factors;
Surgery, Oral;
Sutures;
Tooth Extraction;
Tranexamic Acid
- From:Journal of the Korean Association of Oral and Maxillofacial Surgeons
2019;45(6):343-350
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVES: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required.MATERIALS AND METHODS: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage.RESULTS: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001).CONCLUSION: A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.
