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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (1): 142-147. doi: 10.19723/j.issn.1671-167X.2025.01.021

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Clinical features and risk factors of patients with oral bleeding in dental emergency

Huaqiu GUO, Zhe WANG, Xue YANG, Jie BAI*()   

  1. Department of Oral Emergency, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
  • Received:2024-10-10 Online:2025-02-18 Published:2025-01-25
  • Contact: Jie BAI E-mail:jiebai1999@163.com
  • Supported by:
    the Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-18B06)

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Abstract:

Objective: To analyze the clinical characteristics and risk factors of patients with oral bleeding. Methods: A retrospective study was performed on patients with oral bleeding in the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2019 to December 2022. The distribution of the patients ' gender, age, cause of bleeding, systemic condition, treatment methods and risk factors of hemostasis methods, and number of visits were analyzed. Results: A total of 4 764 patients with oral bleeding were enrolled, including 2 660 males (55.84%) and 2 104 females (44.16%), with an average age of 40.7 years. The most common causes of oral bleeding were bleeding after tooth extraction (3 080 cases, 64.65%), followed by gingival bleeding (1 386 cases, 29.09%), bleeding after outpatient surgery (194 cases, 4.07%), maxillofacial mass bleeding (33 cases, 0.69%), postoperative bleeding of inpatient (24 cases, 0.50%), and bleeding from other causes (47 cases, 0.99%). Simple hemostatic methods were applied in 1 867 cases (39.19%) while 2 897 cases (60.81%) used complex methods, among which iodine strip tamponade and suture were the most commonly used methods of hemostasis. Logistic regression analysis showed that the male patients had a higher proportion of complex methods than the female patients; gingival bleeding were often stopped by simple hemostatic methods while complex methods were more likely to be applied in the patients with bleeding after tooth extraction. The patients with hypertension and coagulation disorders were more likely to visit the hospital for repeated bleeding. Gender and age did not affect the number of visits. Conclusion: Oral bleeding was one of the common diseases in oral emergency. The common causes were bleeding after tooth extraction and gingival bleeding. Most patients could be treated by compression, local suture and packing of iodine strips while some cases with severe bleeding needed further treatment to stop bleeding. A minority of patients with oral bleeding could induce systemic complications, which should be paid full attention by clinicians.

Key words: Oral emergency, Bleeding, Risk factors, Hemostasis

CLC Number: 

  • R78

Table 1

Clinical characteristics of patients with oral bleeding"

Variables n %
Gender
  Male 2 660 55.84
  Female 2 104 44.16
Age/years
  0-9 27 0.57
  10-19 131 2.75
  20-29 1 581 33.19
  30-39 1 235 25.92
  40-49 398 8.35
  50-59 427 8.96
  60-69 471 9.89
  70-79 284 5.96
  ≥80 210 4.41
Visiting time
  0:00-6:00 1 242 26.07
  6:00-12:00 609 12.78
  12:00-18:00 601 12.62
  18:00-24:00 2 312 48.53
Cause of bleeding
  Tooth extraction 3 080 64.65
  Gingival bleeding 1 386 29.09
  Outpatient surgery 194 4.07
  Tumor 33 0.69
  Inpatient surgery 24 0.50
  Others 47 0.99

Table 2

Hemostatic methods for oral bleeding"

Method n %
Simple
  Compression 1 867 39.19
Complex
  Lodine strip tanponade 1 036 21.75
  Other material tanponade 252 5.29
  Suture 611 12.83
  Tanponade+suture 875 18.37
  Local hemostatic medicine 79 1.66
  Others* 44 0.92

Table 3

Analysis of risk factors related to hemostasis methods"

Items Hemostatic methods, n (%) Univariate analysis Binary Logistic regression
Simple Complex P χ2 P OR (95%CI)
Gender 0.003 8.733
  Female 874 (41.54) 1 230 (58.46)
  Male 993 (37.33) 1 667 (62.67) 0.002* 1.228 (1.082-1.394)
Age/years < 0.001 30.746
  0-9 13 (48.15) 14 (51.85) 0.499
  10-19 50 (38.17) 81 (61.83) 0.807 1.115 (0.464-2.682)
  20-29 557 (35.23) 1 024 (64.77) 0.402 1.411 (0.631-3.155)
  30-39 461 (37.33) 774 (62.67) 0.371 1.445 (0.645-3.237)
  40-49 166 (41.71) 232 (58.29) 0.371 1.458 (0.638-3.334)
  50-59 186 (43.56) 241 (56.44) 0.188 1.744 (0.762-3.993)
  60-69 216 (45.86) 255 (54.14) 0.199 1.725 (0.751-3.959)
  70-79 123 (43.31) 161 (56.69) 0.203 1.735 (0.743-4.054)
  ≥80 95 (45.24) 115 (54.76) 0.162 1.857 (0.78-4.419)
Cause of bleeding < 0.001 601.957
  Gingival bleeding 910 (65.66) 476 (34.34) < 0.001* 0.207 (0.107-0.398)
  Tooth extraction 834 (27.08) 2 246 (72.92) 0.566 1.212 (0.628-2.338)
  Outpatient surgery 85 (43.81) 109 (56.19) 0.081 0.533 (0.262-1.082)
  Inpatient surgery 10 (41.67) 14 (58.33) 0.261 0.550 (0.194-1.561)
  Tumor 15 (45.45) 18 (54.55) 0.084 0.434 (0.168-1.120)
  Others▲ 13 (27.66) 34 (72.34)
Physical condition < 0.001 32.721
  Healthy 1 319 (36.93) 2 253 (63.07) 0.485
  Hypertension 138 (45.10) 168 (54.90) 0.355 1.148 (0.857-1.537)
  Coagulation disorder 380 (46.40) 429 (52.38) 0.339 1.117 (0.890-1.403)
  Other diseases 30 (38.96) 47 (61.04) 0.206 1.390 (0.834-2.316)

Table 4

Analysis of risk factors related to number of visits"

Items Number of visits, n (%) Univariate analysis Binary Logistic regression
Single visit Multiple visit P χ2 P OR (95%CI)
Gender 0.053 3.737
  Female 1 760 (83.65) 344 (16.35)
  Male 2 190 (82.33) 470 (17.67) 0.293 1.091 (0.928-1.282)
Age/years < 0.001 101.438
  0-9 25 (92.59) 2 (7.41)
  10-19 124 (94.66) 7 (5.34) 0.986 0.985 (0.185-5.257)
  20-29 1 364 (86.27) 217 (13.73) 0.175 2.815 (0.632-12.542)
  30-39 1 052 (85.18) 183 (14.82) 0.175 2.816 (0.632-12.558)
  40-49 339 (85.18) 59 (14.82) 0.428 1.844 (0.406-8.385)
  50-59 341 (79.86) 86 (20.14) 0.502 1.677 (0.370-7.589)
  60-69 360 (76.43) 111 (23.57) 0.561 1.565 (0.346-7.078)
  70-79 212 (74.65) 72 (25.35) 0.510 1.667 (0.363-7.614)
  ≥80 133 (63.33) 77 (36.67) 0.297 2.248 (0.49-10.322)
Cause of bleeding < 0.001 204.906
  Gingival bleeding 1 009(25.50) 377 (46.30) 0.720 1.132 (0.573-2.237)
  Tooth extraction 2 718 (68.80) 362 (44.50) 0.068 0.528 (0.265-1.049)
  Outpatient surgery 156 (3.90) 38 (4.70) 0.900 1.050 (0.489-2.257)
  Inpatient surgery 19 (0.50) 5 (0.60) 0.995 1.004 (0.296-3.403)
  Tumor 14 (0.40) 19 (2.30) 0.001* 5.872 (2.166-15.919)
  Others▲ 34 (0.90) 13 (1.60)
Physical condition < 0.001 282.802
  Healthy 3 129 (79.20) 443 (54.40)
  Hypertension 242 (6.10) 64 (7.90) 0.001* 1.852 (1.306-2.625)
  Coagulation disorder 511 (12.90) 298 (36.60) < 0.001* 4.202 (3.232-5.463)
  Other diseases 68 (1.70) 9 (1.10) 0.547 0.797 (0.382-1.66)

Table 5

Overview of emergency patients with oral bleeding"

Patient No. Gender Age/years Physical condition Cause of bleeding Reason for rescue Prognosis Others
1 Female 65 Other disease Maxillofacial mass Airway obstruction, Hemorrhagic shock Stable vital signs History of radiotherapy
2 Male 67 Healthy Maxillofacial mass Airway obstruction Stable vital signs History of radiotherapy and chemotherapy
3 Male 26 Healthy Tooth extraction Hypoglycemia Stable vital signs
4 Male 53 Healthy Maxillofacial mass Hemorrhagic shock Stable vital signs
5 Male 55 Hypertension Maxillofacial mass Airway obstruction Stable vital signs History of radiotherapy
6 Male 45 Hypertension Tooth extraction Vasovagal syncope Stable vital signs
7 Male 62 Healthy Mandibular mass Hemorrhagic shock Stable vital signs
8 Male 64 Healthy Maxillofacial mass Hemorrhagic shock Stable vital signs History of radiotherapy
9 Male 76 Coagulation disorder Maxillofacial mass Hemorrhagic shock Stable vital signs History of radiotherapy
10 Male 51 Hypertension Tooth extraction Vasovagal syncope Stable vital signs
11 Male 52 Healthy Maxillofacial mass Airway obstruction Stable vital signs
12 Female 66 Diabetes Maxillofacial mass Hemorrhagic shock Stable vital signs
13 Female 62 Hypertension Maxillofacial mass Respiratory and circulatory failure Death
14 Male 61 Cachexia Maxillofacial mass Respiratory and circulatory failure Death
15 Male 54 Other disease Maxillofacial mass Respiratory and circulatory failure Death
16 Male 65 Cachexia Maxillofacial mass Hemorrhagic shock Stable vital signs History of radiotherapy and multiple surgeries
17 Male 50 Other disease Maxillofacial mass Airway obstruction Stable vital signs
18 Male 65 Cachexia Maxillofacial mass Airway obstruction, Hemorrhagic shock Stable vital signs
19 Male 54 Other disease Maxillofacial mass Airway obstruction Stable vital signs
20 Male 67 Coagulation disorder Gingival bleeding Hemorrhagic shock Stable vital signs Cerebral infarction
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