Safety analysis of tooth extraction in elderly patients with cardiovascular diseases
Ping Lu1, Yiwen Gong1, Yi Chen1
1Department of Geriatrics, Affiliated Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).
Insights
Tooth extraction is safe for elderly patients with cardiovascular diseases, but advanced age and comorbidities increase risks. Holter monitoring better detects cardiac events in high-risk individuals.
Area of Science:
- Cardiology
- Geriatric Medicine
- Dental Surgery
Background:
- Elderly patients often have cardiovascular diseases, posing risks during dental procedures.
- Tooth extraction is a common procedure, necessitating safety evaluations in vulnerable populations.
Purpose of the Study:
- To assess the safety of tooth extraction in elderly patients with cardiovascular diseases.
- To identify factors influencing the safety of tooth extraction in this demographic.
- To compare cardiovascular event detection methods during the procedure.
Main Methods:
- Analysis of 13,527 tooth extractions, focusing on elderly patients with comorbidities.
- Cardiac monitoring of 7,077 elderly patients with hypertension and other chronic conditions.
- Comparison of general vs. Holter monitoring for cardiovascular events in 89 hypertensive patients.
Main Results:
- Elderly patients (75.3%) underwent extraction, with the 70-79 age group most represented.
- Hypertension, coronary heart disease, and arrhythmia were the most frequent comorbidities.
- Holter monitoring detected significantly more cardiovascular events than general monitoring.
Conclusions:
- Tooth extraction is generally safe for elderly patients with cardiovascular diseases, but risks increase with age and comorbidity burden.
- Hypertension is the most common comorbidity, followed by coronary heart disease and arrhythmia.
- Holter monitoring is superior for detecting cardiovascular events in high-risk elderly patients undergoing tooth extraction.
Background:
This study aimed to evaluate the safety of tooth extraction in elderly patients with cardiovascular diseases.
Material And Methods:
A total of 13 527 patients underwent tooth extraction at the Affiliated Ninth People's Hospital of Shanghai Jiaotong University. Age, sex, and diseases were analyzed. Cardiac monitoring during tooth extraction was performed in 7077 elderly patients with hypertension and other chronic diseases, and the influence of various factors on safety of tooth extraction was evaluated. Additionally, 89 patients with primary hypertension were recruited, and electrocardiogram was monitored with a general monitor or a Holter monitor, and the detection rate of cardiovascular events was compared between the 2 groups.
Results:
The elderly accounted from 75.3%, and patients aged 70-79 years had highest proportion. The most frequent comorbidities were hypertension, coronary heart disease, arrhythmia, cerebrovascular accident, and diabetes. In analysis of factors influencing the safety of tooth extraction in the elderly, a significant difference was noted in systolic blood pressure at different time points. In addition, change in heart rate was different between males and females. Detection rate of cardiovascular events by use of a Holter monitor was significantly higher than with a general monitor.
Conclusions:
Hypertension was the most common comorbidity in elderly patients undergoing tooth extraction, followed by coronary heart disease and arrhythmia. Advanced age and increased comorbidity may increase the risk of complications. Risk score can be used to rapidly determine risk for complications during tooth extraction. The Holter monitor is superior to the general monitor in identifying cardiovascular events in high-risk elderly patients undergoing tooth extraction, and can be used in this population.
Related Concept Videos
01:15Drug Dosing: Geriatric Patients
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:26Cardiac Catheterization IV: Nursing Management