Should warfarin be discontinued before a dental extraction? A decision-tree analysis

被引：15

作者：

Balevi, Ben ^{[1
]}

机构：

[1] Univ British Columbia, Fac Med, Vancouver, BC V5Z 1M9, Canada

来源：

ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTOLOGY | 2010年 / 110卷 / 06期

关键词：

ORAL ANTICOAGULANTS; PERIOPERATIVE MANAGEMENT; SURGERY; THERAPY;

D O I：

10.1016/j.tripleo.2010.03.018

中图分类号：

R78 [口腔科学];

学科分类号：

1003 ;

摘要：

Objective. The aim of this study was to determine if warfarin should be withdrawn before a single tooth extraction on a patient with a prosthetic heart valve. Study design. A quantitative decision tree was constructed to assess the expected utility values of 2 typical strategies to manage the dental extraction on a patient currently medicated with warfarin. Probabilities and utilities for a cardiovascular accident and major bleeding from a dental extraction were taken from the literature. Results. The decision slightly favors withholding warfarin: generating an optimal expected utility value of 0.976 utile. This was only 0.02 utile higher than the alternative option of continuing warfarin for a dental extraction. Conclusion. The decision to withhold or continue warfarin before a dental extraction depends more on the relative risk of a major bleeding between the 2 medical management strategies than on the consequences of a cardiovascular accident. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:691-697)

引用

页码：691 / 697

页数：7

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