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World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta‐analysis
Author(s) -
Manfredi Maddalena,
Dave Bella,
Percudani Daniela,
Christoforou Janina,
Karasneh Jumana,
Diz Dios Pedro,
Glick Michael,
Kumar Navdeep,
Lockhart Peter B.,
Patton Lauren L.
Publication year - 2019
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.13086
Subject(s) - medicine , meta analysis , cochrane library , oral anticoagulant , medline , randomized controlled trial , data extraction , systematic review , oral medicine , surgery , warfarin , atrial fibrillation , dentistry , political science , law
Objectives This systematic review aimed to evaluate the current literature regarding the importance of discontinuing or not discontinuing direct oral anticoagulants ( DOAC s) before invasive oral procedures, and to establish the frequency and type of postoperative bleeding events in patients. Material and Methods We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library up until November 5, 2018. Selection of the studies, extraction of data, qualitative, and bias assessment was performed independently by two authors. Results Twenty‐one studies were included. No randomized controlled studies were identified. Six studies reported a direct comparison between patients taking DOAC s and those who discontinued DOAC s. The meta‐analysis of these studies resulted in an OR of 0.92 (95% CI = 0.37–2.27, I 2 = 9%) for postoperative bleeding events for patients taking DOAC s. We found that 59/497 (11.8%) postoperative bleeding events occurred in patients who continued DOAC s, while 27/200 (13.5%) events were reported for patients who discontinued treatment. All postoperative bleeding events were controlled with local measures. Conclusion Results from the included studies did not discern any important differences in postoperative bleeding events in patients who continued versus patients who discontinued DOAC s. Furthermore, no thromboembolic events were recorded. However, the low quality of the studies must be considered.