在患有心血管疾病的老年患者中,拔牙期间发生不良事件的预测性风险因素
Shaojun Ma1, Xu Chen1, Yurun Zhai1
1Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Annals of medicine
|January 2, 2025
概括
一个新的预测模型确定了11个因素,以评估心血管疾病的老年患者在拔牙期间的不良事件风险. 这种工具有助于管理这个弱势群体的风险.
科学领域:
- 心脏病学 心脏病学
- 牙科手术 牙科手术
- 老年病的医生 老年病的医生
背景情况:
- 拔牙带来心血管事件的风险,特别是在老年人中.
- 目前没有临床工具可以预测牙拔牙过程中的不良事件 (AE).
- 患有心血管疾病 (CVD) 的老年患者代表了牙科手术期间AEs的高风险群体.
研究的目的:
- 开发和验证一种预测模型,用于预测心血管疾病的老年患者在拔牙过程中发生的不良事件.
- 在这个患者群体中确定与AE相关的关键风险因素.
主要方法:
- 预期招募774名患有心血管疾病的老年患者 (≥60岁) 进行牙拔除.
- 收集和分析62个潜在的风险因素,包括一般,临床和外科特征.
- 使用逻辑回归的预测模型的开发,包括单变量和多变量分析与逐步选择.
主要成果:
- 建立了一个预测模型,结合了11个重要因素,如年龄,血压,中风病史和心理健康状况 (一般健康问卷28分).
- 该模型表现出良好的预测性能,测试组的曲线下的面积为0.893,验证组的面积为0.857.
- 发现的关键预测因素包括精神状态和血压,突出了它们在拔牙过程中对异常事件的关键作用.
结论:
- 一个具有11个临床因素的验证预测模型有效地评估了心血管疾病的老年患者在拔牙期间发生意外事件的风险.
- 开发的诺米图为临床医生提供了一个有价值的工具,用于预测和管理这种高风险组的潜在不良事件.
- 精神状态和血压是影响牙拔牙患者不良反应预测的关键因素.
相关概念视频
01:23Assessment of the Cardiovascular System I: Subjective Data
235
A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
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...
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...
235
01:25Errors occurring during blood pressure monitoring
565
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
565
01:15Teeth
237
The formation of teeth, also known as odontogenesis, is a complex process that begins in utero, around the sixth week of embryonic development. There are three stages to this process: the bud stage, the cap stage, and the bell stage.
In the bud stage, the tooth germ (an aggregation of cells) starts to form in the developing jawbone. During the cap stage, the tooth germ differentiates into enamel organ, dental papilla, and dental sac, which will later develop into the tooth's enamel, dentin...
In the bud stage, the tooth germ (an aggregation of cells) starts to form in the developing jawbone. During the cap stage, the tooth germ differentiates into enamel organ, dental papilla, and dental sac, which will later develop into the tooth's enamel, dentin...
237
01:20Exercise and Cardiovascular Response
637
Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
637
01:20Imaging Studies for Cardiovascular System III: X-Ray
104
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
104
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
509
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
509