Should warfarin be discontinued before a dental extraction? A decision-tree analysis
- PMID: 20580276
- DOI: 10.1016/j.tripleo.2010.03.018
Should warfarin be discontinued before a dental extraction? A decision-tree analysis
Abstract
Objective: The aim of this study was to determine if warfarin should be withdrawn before a single tooth extraction on a patient with a prosthetic heart valve.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.
Copyright © 2010 Mosby, Inc. All rights reserved.
Comment in
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Bleed or die? A bloody simple decision.Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Feb;113(2):147-8; author reply 150-2. doi: 10.1016/j.tripleo.2011.01.049. Epub 2011 Oct 19. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012. PMID: 22677724 No abstract available.
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Evidence does not support the discontinuation of warfarin before a dental extraction.Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Feb;113(2):148-9; author reply 150-2. doi: 10.1016/j.tripleo.2011.02.054. Epub 2011 Aug 26. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012. PMID: 22677725 No abstract available.
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Should warfarin be discontinued before a dental extraction?Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Feb;113(2):149-50; author reply 150-2. doi: 10.1016/j.tripleo.2011.02.055. Epub 2011 Oct 26. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012. PMID: 22677726 No abstract available.
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Anticoagulation in dental surgery: Is it rude to interrupt?Cleve Clin J Med. 2016 Jun;83(6):409-13. doi: 10.3949/ccjm.83a.15014. Cleve Clin J Med. 2016. PMID: 27281251 No abstract available.
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