Blood investigations prior to oral surgery for suspected alcohol-induced coagulopathy. Are they necessary?

ABSTRACT

OBJECTIVE: To evaluate the current practice of pre-oral surgery haematological investigation in patients with disclosed regular and prolonged high alcohol consumption above the national recommendation for coagulopathy due to potential alcohol induced liver impairment. DESIGN: Retrospective analysis of data.Setting University of Bristol Dental Hospital, United Kingdom, 2013.Subjects Adults (over 16 years old) with a reported high alcohol intake with no history of non-alcohol-related liver impairment or pre-existing coagulopathy.Main outcome measures Alcohol and bleeding history recorded, haematology test requested with results and actions for abnormal results. RESULTS: From a sample size of 58 patients, 75.9% of cases had their alcohol intake recorded; only 10.3% of cases had the duration of drinking recorded. Bleeding history was recorded in 82.9% of cases to which 6.9% of cases had a positive bleeding history. The most common combination of tests requested was full blood count, coagulation screen and liver function test. In 46.6% of cases, results were out of range - in all cases but 1, the patients abnormal haematology results were not followed up further. CONCLUSION: It was found that 1.7% of cases met the locally agreed standard (from best available evidence) that haematology requests, including full blood count and coagulation screen, should only be undertaken in those with disclosed high alcohol intake and positive bleeding history. A consistent bleeding history and alcohol intake should always be documented thoroughly.