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Original Article
Risk of Hemorrhage Attributed to Underlying Chronic Diseases and Uninterrupted Aspirin Therapy of Patients Undergoing Minor Oral Surgical Procedures: A Retrospective Cohort Study
Chanapong Rojanaworarit, Soontaree Limsawan
J Prev Med Public Health. 2017;50(3):165-176.   Published online April 7, 2017
DOI: https://doi.org/10.3961/jpmph.16.121
  • 6,783 View
  • 264 Download
AbstractAbstract PDF
Objectives
This study aimed to estimate the risk of bleeding following minor oral surgical procedures and uninterrupted aspirin therapy in high-risk patients or patients with existing chronic diseases compared to patients who did not use aspirin during minor oral surgery at a public hospital.
Methods
This retrospective cohort study analyzed the data of 2912 patients, aged 20 years or older, who underwent 5251 minor oral surgical procedures at a district hospital in Thailand. The aspirin group was comprised of patients continuing aspirin therapy during oral surgery. The non-aspirin group (reference) included all those who did not use aspirin during surgery. Immediate and late-onset bleeding was evaluated in each procedure. The risk ratio of bleeding was estimated using a multilevel Poisson regression.
Results
The overall cumulative incidence of immediate bleeding was 1.3% of total procedures. No late-onset bleeding was found. A significantly greater incidence of bleeding was found in the aspirin group (5.8% of procedures, p<0.001). After adjusting for covariates, a multilevel Poisson regression model estimated that the bleeding risk in the aspirin group was 4.5 times higher than that of the non-aspirin group (95% confidence interval, 2.0 to 10.0; p<0.001). However, all bleeding events were controlled by simple hemostatic measures.
Conclusions
High-risk patients or patients with existing chronic diseases who continued aspirin therapy following minor oral surgery were at a higher risk of hemorrhage than general patients who had not used aspirin. Nonetheless, bleeding complications were not life-threatening and could be promptly managed by simple hemostatic measures. The procedures could therefore be provided with an awareness of increased bleeding risk, prepared hemostatic measures, and postoperative monitoring, without the need for discontinuing aspirin, which could lead to more serious complications.
Summary
English Abstract
Body Mass Index and Risk of Hemorrhagic Stroke in Korean Adults: Case-control Study.
Seon Ha Kim, Yong Seok Lee, Seung Mi Lee, Byung Woo Yoon, Byung Joo Park
J Prev Med Public Health. 2007;40(4):313-320.
DOI: https://doi.org/10.3961/jpmph.2007.40.4.313
  • 4,513 View
  • 59 Download
  • 4 Crossref
AbstractAbstract PDF
OBJECTIVES
To evaluate the association between body mass index (BMI) and hemorrhagic stroke. METHODS: A case-control study was conducted on 2,712 persons (904 cases, 904 hospital controls, and 904 community controls) participating in an Acute Brain Bleeding Analysis study from October 2002 to March 2004. Two controls for each case were matched according to age and gender. The information was obtained by trained interviewers using standardized questionnaire. A conditional logistic regression model was used to estimate the association between BMI and the frequency of having a hemorrhagic stroke. RESULTS: Obese men (25.0 < or = BMI < 30.0 kg/m2) had an odds ratios (OR) of 1.39 (95% CI 1.03 to 1.87) a hemorrhagic stroke, compared to men with a normal BMI (18.5 to 24.9 kg/m2). Conversely, women with lower BMI had a higher risk of having hemorrhagic stroke. With respect to subtypes of hemorrahagic stroke, we observed about a three-fold increase in the risk of intracerebral hemorrhage (ICH) in the highly obese group. However, these trends were not significant in patients with subarachnoid hemorrhages. CONCLUSIONS: Obesity was identified as one of the risk factors in hemorrhagic stroke, in particular ICH. Conversely, in women, a lean body weight increases the risk of hemorrhagic stroke. Consequently, managing one\s weight is essential to reduce the risks of hemorrhagic stroke.
Summary

Citations

Citations to this article as recorded by  
  • Is nontraumatic intracerebral hemorrhage different between young and elderly patients?
    Na Rae Yang, Ji Hee Kim, Jun Hyong Ahn, Jae Keun Oh, In Bok Chang, Joon Ho Song
    Neurosurgical Review.2020; 43(2): 781.     CrossRef
  • Follow-up study on mortality in Korean stroke patients
    Jee Hye Im, Kun Sei Lee, Keon Yeop Kim, Nam Soo Hong, Sang Won Lee, Hee Joon Bae
    Journal of the Korean Medical Association.2011; 54(11): 1199.     CrossRef
  • Potential bias caused by control selection in secondary data analysis: Nonaspirin nonsteroidal anti‐inflammatory drugs and hemorrhagic stroke
    Nam‐Kyong Choi, Seokyung Hahn, Byung‐Woo Yoon, Byung‐Joo Park
    Pharmacoepidemiology and Drug Safety.2010; 19(6): 604.     CrossRef
  • Socioeconomic Costs of Stroke in Korea: Estimated from the Korea National Health Insurance Claims Database
    Seung-ji Lim, Han-joong Kim, Chung-mo Nam, Hoo-sun Chang, Young-Hwa Jang, Sera Kim, Hye-Young Kang
    Journal of Preventive Medicine and Public Health.2009; 42(4): 251.     CrossRef
JPMPH : Journal of Preventive Medicine and Public Health
© Korean Society for Preventive Medicine.
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