RISK FACTORS FOR POST-EXODONTIA BLEEDING IN PATIENTS WITH TERMINAL HEPATIC DISEASE: A STROBE-GUIDED PROSPECTIVE COHORT

Abstract

<h3>Objectives</h3> To assess the incidence and risk factors to post-exodontia bleeding in patients with terminal hepatic disease (THD) . <h3>Study Design</h3> This cohort study prospectively evaluated patients before liver transplant needing exodontia. All exodontias were performed using a hemostatic sponge or a local compress with a gauze pad soaked in tranexamic acid, according to the size of the alveolus. Bleeding was assessed according to the presence and bleeding period criteria in the first 30 minutes and during the next 7 days. Fisher's exact test, chi-square test, and multinomial regression models were performed (SPSS; <i>P</i> < .05). <h3>Results</h3> Postoperative bleeding reduced significantly from first (56%), second (16%), third (8%) and fourth (4%) postoperative days and type of hemostatic, and the number (1, 2, or 3) and distribution (distant or contiguous) of teeth did not influence this outcome. Low blood cell count (<i>P</i> = .037), hemoglobin (<i>P</i> = .004), hematocrit (<i>P</i> = .037) and international normalized ratio (<i>P</i> = .013) predicted postoperative bleeding, such as ascites (<i>P</i> = .006), peritonitis (<i>P</i> < .001), and encephalitis (<i>P</i> = .004), but in multivariate analysis the risk factors were male sex (<i>P</i> = .004) and previous gingival bleeding (<i>P</i> = .038). <h3>Conclusions</h3> A low incidence of post-exodontia bleeding was observed during local hemostatic agents use, and gingival bleeding is the most important risk factor for post-exodontia bleeding in patients with THD.