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Master thesis

Enquête réalisée auprès de 200 médecins généralistes et dentistes de Lorraine concernant la conduite à tenir vis-à-vis des antivitamines K chez des patients nécessitant un acte chirurgical dentaire

Abstract : In 1998, the systematic review of M.J.Wahl marked a turning point in the management of anticoagulants in case of dental surgery by publishing the synthesis of 26 publications. This review of the literature indicated that thereis a risk of bleeding during dental surgery under VKA, but this risk is minimal in comparison with the thromboembolic risks, sometimes fatal, occuring when when the anticoagulants are stopped. Continuing AVK should consequently be the rule if a good quality hemostasis can be obtained.ln 2006 and thanks to the initiative of SFMBCB and SFC, the first recommendations in French language on this subject and aiming at standardizing practices were published.The objective of this study was to assess knowledge and application of this recommendation by health professionals. 200 dentists and general practitionerswere interviewed by means of a questionnaire consisting ofa general section and 4 clinical cases with varied risks of Thromboembolism and of bleeding.This recommendation seems widely known and better by the dentists. It seems weil applied for situaIions combining extreme risks but sub-optimal responses remain 100 frequent for situations at intermediate risk.On the cont rary, the positive impact of the reco mmendation is indisputable: physicians take less high-risk decisions when they know the recommendation. An essential point is finally also raised : the transmission of information is not optimal. A document intended for the general practitioner could be completed by dentists, aspecific page about the management of anticoagulants during dental care could be inserted in the "anticoagulant noteb ook" to inform the patient. Finally, a summary of the recommendation could be made available to the dentists and the general practitioners. Such diffusion of the information is the basis for an improved quality of healthcare.
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https://hal.univ-lorraine.fr/hal-01732625
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  • HAL Id : hal-01732625, version 1

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Emilie Farese. Enquête réalisée auprès de 200 médecins généralistes et dentistes de Lorraine concernant la conduite à tenir vis-à-vis des antivitamines K chez des patients nécessitant un acte chirurgical dentaire. Sciences du Vivant [q-bio]. 2009. ⟨hal-01732625⟩

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