J Korean Assoc Oral Maxillofac Surg 2019; 45(6): 343~350
When do we need more than local compression to control intraoral haemorrhage?
Jun-Bae Sohn1, Ho Lee1, Yoon-Sic Han1, Da-Un Jung2, Hye-Young Sim2, Hee-Sun Kim2, Sohee Oh3
1Department of Oral and Maxillofacial Surgery, Seoul Metropolitan Government-Seoul National University (SMG-SNU) Boramae Medical Center, Seoul,
2Section of Dentistry, SMG-SNU Boramae Medical Center, Seoul,
3Medical Research Collaborating Center, SMG-SNU Boramae Medical Center, Seoul, Korea
Ho Lee
Department of Oral and Maxillofacial Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea
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Received August 17, 2019; Revised October 5, 2019; Accepted October 28, 2019.; Published online December 31, 2019.
© The Korean Association of Oral and Maxillofacial Surgeons.. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 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.
Keywords: Haemorrhage, Emergency treatment, Haemostasis, Anticoagulants, Oral surgery


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31 December 2019
Vol. 45
No. 6 pp. 301~378

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