Data from: Risks of postextraction bleeding after receiving direct oral anticoagulants or warfarin: a retrospective cohort study

Objective: The effect of direct oral anticoagulants (DOACs) on the risk of bleeding after tooth extraction remains unclear. This study aimed to evaluate the incidence of post-extraction bleeding among patients who received DOAC and vitamin K antagonists (VKAs), such as warfarin. Design: This study was a retrospective cohort analysis. Incidence rates and propensity score matched regression models were used to compare the risks of bleeding after tooth extractions involving DOACs and VKAs. Setting: The study took place in a single university hospital in Japan. Participants: Between April 2013 and April 2015, 543 patients underwent a total of 1,196 simple tooth extractions. Primary outcome measure: The primary outcome measure was the occurrence of post-extraction bleeding, which was defined as bleeding that could not be stopped by biting down on gauze and required medical treatment between 30 minutes and 7 days after the extraction. Results: A total of 1,196 tooth extractions (634 procedures) in 541 patients fulfilled the study criteria, with 72 extractions (41 procedures) involving DOACs, 100 extractions (50 procedures) involving VKAs, and 1,024 extractions (543 procedures) involving no anticoagulants. The incidences of post-extraction bleeding per tooth for the DOAC, VKA, and no anticoagulant extractions were 10.4%, 12.0%, and 0.9%, respectively. The incidences of post-extraction bleeding per procedure for DOACs, VKAs, and no anticoagulants were 9.7%, 10.0%, and 1.1%, respectively. In comparison to the VKA extractions, the DOAC extractions did not significantly increase the risk of post-extraction bleeding (odds ratio: 0.69; 95% confidence intervals: 0.24–1.97; p=0.49). Conclusions: The risk of post-extraction bleeding was similar for DOAC and VKA extractions.目的：直接口服抗凝药（direct oral anticoagulants, DOACs）对拔牙术后出血风险的影响目前尚不明确。本研究旨在评估接受DOACs与华法林（warfarin）等维生素K拮抗剂（vitamin K antagonists, VKAs）治疗的患者的拔牙后出血发生率。 研究设计：本研究为回顾性队列分析。采用发生率统计与倾向得分匹配回归模型，对比使用DOACs与VKAs的患者拔牙后出血风险。 研究场景：本研究在日本的一所单中心大学附属医院开展。 研究对象：2013年4月至2015年4月期间，543例患者共接受1196例单纯拔牙手术。 主要结局指标：主要结局指标为拔牙后出血事件，定义为拔牙后30分钟至7天内，无法通过咬压棉球止血且需接受医疗干预的出血情况。 研究结果：共有541例患者的1196例拔牙手术（共计634次操作）符合研究纳入标准，其中72例拔牙（41次操作）使用DOACs，100例拔牙（50次操作）使用VKAs，1024例拔牙（543次操作）未使用抗凝药物。按单颗牙齿统计，DOACs组、VKAs组与未使用抗凝药物组的拔牙后出血发生率分别为10.4%、12.0%与0.9%。按单次操作统计，三组的拔牙后出血发生率分别为9.7%、10.0%与1.1%。与VKAs组相比，DOACs组患者拔牙后出血风险无显著升高（比值比：0.69；95%置信区间：0.24~1.97；P=0.49）。 结论：DOACs与VKAs使用者的拔牙后出血风险相似。