Predictive risk factors for adverse events during tooth extraction among elderly patients with cardiovascular diseases
Background Tooth extraction is a risk factor for cardiovascular events, particularly in elderly patients. However, no clinical tool has been developed to date to predict the risk of adverse events (AEs) during tooth extraction.Materials and Methods We prospectively enrolled 774 elderly patients (age...
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| Format: | Article |
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2024.2448274 |
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| author | Shaojun Ma Xu Chen Yurun Zhai Xinyi Sun Jing Sheng Yun Sun Haiya Wang |
| author_facet | Shaojun Ma Xu Chen Yurun Zhai Xinyi Sun Jing Sheng Yun Sun Haiya Wang |
| author_sort | Shaojun Ma |
| collection | DOAJ |
| description | Background Tooth extraction is a risk factor for cardiovascular events, particularly in elderly patients. However, no clinical tool has been developed to date to predict the risk of adverse events (AEs) during tooth extraction.Materials and Methods We prospectively enrolled 774 elderly patients (aged ≥ 60 years) with cardiovascular disease (CVD) who were scheduled to undergo tooth extraction at the dental surgery department of Shanghai Ninth People’s Hospital from January 2021 to July 2022. To determine the predictive risk factors for AEs, we collected and recorded 62 factors on general characteristics, clinical information, physical and imaging examinations, psychological tests, perioperative characteristics, and surgical characteristics.Results We used a univariate logistic regression model to explore the 62 potential risk factors and included 21 factors in a multivariate model (all P-values < 0.05). After stepwise selection, 11 factors, including age, systolic blood pressure, severe hypertension, history of pacemaker use, stroke, ejection fraction, valvular insufficiency, atrial premature beats, ventricular premature beats, extraction of more than one tooth and the General Health Questionnaire-28 score, were included in the predictive model (all P-values < 0.05). In the test group, the area under the curve was 0.893 (0.866, 0.919), sensitivity was 0.878 (0.827, 0.93), specificity was 0.735 (0.697, 0.773) and accuracy was 0.768 (0.736, 0.800). In the validation group, these values were 0.857 (0.760, 0.954), 0.938 (0.819, 1.056) and 0.524 (0.417, 0.631), respectively. We created a nomogram to predict the risk factors for AEs during tooth extraction. Mental status plays a critical role in the risk of adverse effects, and the blood pressure also has a key influence on the prediction of adverse effects.Conclusions We developed and validated a predictive model with 11 clinical factors for the AEs during tooth extraction in elderly patients with CVD with well efficiency. |
| format | Article |
| id | doaj-art-c369e73dab4e41ddb0574a9efa495424 |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-c369e73dab4e41ddb0574a9efa4954242025-01-03T00:38:38ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2024.2448274Predictive risk factors for adverse events during tooth extraction among elderly patients with cardiovascular diseasesShaojun Ma0Xu Chen1Yurun Zhai2Xinyi Sun3Jing Sheng4Yun Sun5Haiya Wang6Department of Geriatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Geriatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Geriatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Geriatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Geriatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Geriatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Geriatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaBackground Tooth extraction is a risk factor for cardiovascular events, particularly in elderly patients. However, no clinical tool has been developed to date to predict the risk of adverse events (AEs) during tooth extraction.Materials and Methods We prospectively enrolled 774 elderly patients (aged ≥ 60 years) with cardiovascular disease (CVD) who were scheduled to undergo tooth extraction at the dental surgery department of Shanghai Ninth People’s Hospital from January 2021 to July 2022. To determine the predictive risk factors for AEs, we collected and recorded 62 factors on general characteristics, clinical information, physical and imaging examinations, psychological tests, perioperative characteristics, and surgical characteristics.Results We used a univariate logistic regression model to explore the 62 potential risk factors and included 21 factors in a multivariate model (all P-values < 0.05). After stepwise selection, 11 factors, including age, systolic blood pressure, severe hypertension, history of pacemaker use, stroke, ejection fraction, valvular insufficiency, atrial premature beats, ventricular premature beats, extraction of more than one tooth and the General Health Questionnaire-28 score, were included in the predictive model (all P-values < 0.05). In the test group, the area under the curve was 0.893 (0.866, 0.919), sensitivity was 0.878 (0.827, 0.93), specificity was 0.735 (0.697, 0.773) and accuracy was 0.768 (0.736, 0.800). In the validation group, these values were 0.857 (0.760, 0.954), 0.938 (0.819, 1.056) and 0.524 (0.417, 0.631), respectively. We created a nomogram to predict the risk factors for AEs during tooth extraction. Mental status plays a critical role in the risk of adverse effects, and the blood pressure also has a key influence on the prediction of adverse effects.Conclusions We developed and validated a predictive model with 11 clinical factors for the AEs during tooth extraction in elderly patients with CVD with well efficiency.https://www.tandfonline.com/doi/10.1080/07853890.2024.2448274Cardiovascular diseasestooth extractionadverse eventelderlyrisk factors |
| spellingShingle | Shaojun Ma Xu Chen Yurun Zhai Xinyi Sun Jing Sheng Yun Sun Haiya Wang Predictive risk factors for adverse events during tooth extraction among elderly patients with cardiovascular diseases Annals of Medicine Cardiovascular diseases tooth extraction adverse event elderly risk factors |
| title | Predictive risk factors for adverse events during tooth extraction among elderly patients with cardiovascular diseases |
| title_full | Predictive risk factors for adverse events during tooth extraction among elderly patients with cardiovascular diseases |
| title_fullStr | Predictive risk factors for adverse events during tooth extraction among elderly patients with cardiovascular diseases |
| title_full_unstemmed | Predictive risk factors for adverse events during tooth extraction among elderly patients with cardiovascular diseases |
| title_short | Predictive risk factors for adverse events during tooth extraction among elderly patients with cardiovascular diseases |
| title_sort | predictive risk factors for adverse events during tooth extraction among elderly patients with cardiovascular diseases |
| topic | Cardiovascular diseases tooth extraction adverse event elderly risk factors |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2024.2448274 |
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