Assessment of perioperative cardiac complications in oral surgery

Hiroshi Hoshijima, Risa Takeuchi, Noriko Onuki, Takeshi Asami, Shinichi Nakamura, Akihiko Hasegawa, Jun Shimada, Hiroshi Nagasaka

Research output: Contribution to journalArticlepeer-review

Abstract

Perioperative cardiac complications are a primarily source of increased cost and morbidity in surgically treated dental patients. However, assessments of perioperative cardiac complications in odontology are rarely reported in the literature. This study investigated potential risk factors related to perioperative cardiac complications, such as cardiac arrest (asystole, ventricular fibrillation (Vf), pulseless electrical activity (PEA), pulseless ventricular tachycardia)), acute myocardial infarction (AMI), ventricular tachycardia (VT), and ST-segment depression or elevation, that may occur during oral surgery. Methods : Data from 1,376 patients (n=1,422) who had undergone oral surgery at the Meikai University School of Dentistry between 1999 and 2003 were retrospectively reviewed. Chi-square analysis and Student t test were used to evaluate perioperative variables identified as potential risk factors for perioperative cardiac complications. Results '. Major perioperative cardiac complications occurred in 8 patients (0.56%). ST-segment depression or elevation was documented in 4 patients, Cardiac standstill was documented in 1 patient. AMI was documented in 2 patients, and VT was documented in 1 patient. Most patients showed improvement in health by appropriate treatments. However, one of the AMI patients died 14 days after surgery. Chi-square analysis and Student t test identified classification of ASA, age (over 71), history of hypertension, history of diabetes mellitus, history of angina pectoris, history of myocardial infarction, preoperative abnormal ECG, preoperative abnormal echocardiogram and neck dissection (p < 0.05) as significant factors associated with cardiac complications. Conclusions : Our study showed that classification of ASA, age (over 71), history of hypertension, history of diabetes mellitus, history of angina pectoris, history of myocardial infarction, preoperative abnormal ECG, preoperative abnormal echocardiogram and neck dissection were significant risk factors for perioperative cardiac complications. Although these risk factors were included in those of AHA guideline and Goldman's modified cardiac risk index, we found that incidences of cardiac complications and cardiac death differed from those of Goldman's.

Original languageEnglish
Pages (from-to)29-35
Number of pages7
JournalJournal of Japanese Dental Society of Anesthesiology
Volume35
Issue number1
Publication statusPublished - 2007 Feb 21
Externally publishedYes

Keywords

  • Age
  • Cardiac complication
  • Classification of asa
  • Neck dissection

ASJC Scopus subject areas

  • Dentistry(all)
  • Anesthesiology and Pain Medicine

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