Riesgo de hemorragia postquirúrgica en pacientes bajo tratamiento antitrombótico sometidos a cirugía oralRevisión Sistemática y Metaanálisis.
- Julio Villanueva 1
- Diego Vergara 1
- Lorena Núñez 1
- Gabriel Zamorano 1
- Sebastián Zapata 1
- Josefina Salazar 1
- Ana Alarcón 1
- Rosa Rojo 2
- Stefan Domancic 1
- Nicolás Yanine 1
- Ignacio Araya 1
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1
Universidad de Chile
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2
Universidad Rey Juan Carlos
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ISSN: 0719-0107
Año de publicación: 2018
Volumen: 11
Número: 2
Páginas: 121-127
Tipo: Artículo
Otras publicaciones en: Revista clínica de periodoncia, implantología y rehabilitación oral
Resumen
RESUMEN: Introducción: el objetivo de esta revisión fue determinar el riesgo de hemorragia postoperatoria en pacientes con tratamiento anticoagulante oral (TACO) sometidos a cirugía oral que no suspenden su tratamiento comparado con quienes lo modifican o suspenden. Materiales y métodos: se realizó una búsqueda en CENTRAL, Medline y EMBASE, junto con una revisión manual de revistas especializadas y resúmenes de la IADR. Dos revisores realizaron la selección de estudios, evaluación de riesgo de sesgo y extracción de datos de forma independiente. Se seleccionaron los ensayos clínicos aleatorizados que miden la aparición de hemorragias en pacientes sometidos a procedimientos quirúrgicos orales con TACO en comparación con un grupo que interrumpió o modificó su terapia. Resultados: Solo 5 estudios cumplieron los criterios de inclusión (549 pacientes). El metanálisis mostró que el mantenimiento de la TACO no aumenta el riesgo de hemorragia postoperatoria (riesgo relativo: 1,41 [0,93 - 2,16], IC del 95% p = 0,11) en comparación con la interrupción del tratamiento. Conclusión: Aunque se encontró una mayor cantidad de hemorragia postoperatoria en pacientes con TACO comparado con quienes lo interrumpieron o modificaron, esta diferencia no fue estadística ni clínicamente significativa. Por lo tanto, TACO no debe suspenderse en pacientes sometidos a cirugía oral.
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