Abstract(s)
Introdução: As características da população que procura a prestação de serviços médico-dentários têm, nos últimos anos, sofrido alterações. Torna-se cada vez mais frequente o atendimento de pacientes medicamente comprometidos. Para evitar que ocorram complicações, os médicos dentistas devem conhecer o estado de saúde dos seus pacientes, através da realização de uma história clínica completa e sistematizada.
Objectivos: Identificar a prevalência de antecedentes médicos (patologias sistémicas e regimes terapêuticos), e avaliar segundo a classificação da ASA o nível de risco médico dos pacientes que solicitam tratamentos médico-dentários.
Materiais e métodos: Foi aplicado um questionário EMRRH aos pacientes de 24 médicos dentistas, que completaram a sua Licenciatura ou Mestrado Integrado em Medicina Dentária, na Universidade Católica Portuguesa, entre os anos de 2006-2010. Determinou-se a frequência das patologias, medicações e o nível de risco médico segundo a classificação ASA. Para o tratamento estatístico da informação colectada utilizaram-se os testes Mann-Whitney, T, Kolmogorov-Smirnov, Rho de Spearman, Kendall’s tau-b, Levéne, Phi e Cramer’s V.
Resultados: Obteve-se uma amostra de 796 pacientes, sendo que destes, 54,8% (n=437) tinham antecedentes médicos relevantes para a prática da medicina dentária. Existiam diferenças estatisticamente significativas, entre a média das idades da população com, e sem antecedentes médicos (p<0,001) e uma correlação positiva entre o número de antecedentes e a idade do participante. A análise do risco médico segundo a classificação ASA demonstrou que dos 796 participantes, 45,2% (n=359) pertenciam à classe ASA I; 32,0% (n=255) à classe ASA II; 10,9% (n=87) à classe ASA III e 11,9% (n=95) à classe IV, verificando-se que os valores mais elevados de nível ASA estavam relacionados com o aumento da idade dos participantes. Entre as várias patologias, a hipertensão foi a observada com maior frequência (16,1%), seguida das arritmias cardíacas (10,2%), angina de peito (8,7%) e reacções alérgicas a fármacos ou dispositivos médicos (8,2%). A prevalência de tratamentos medicamentosos foi de 35,5%, sendo a maioria referente à terapêutica antihipertensora (12,2%).
Conclusão: A realização de uma história clínica completa e sistematizada, aliada à determinação do nível de risco médico de cada paciente, permite a identificação das condições fisiopatológicas que requerem modificações do plano de tratamento dentário evitando emergências médicas. O questionário EMRRH, por reunir as valências mencionadas, é considerado uma ferramenta útil para a boa prática da Medicina Dentária.
Introduction: The population seeking dental care has been changing over the recent years. The frequency of treatments in medically compromised patients has increased. To prevent complications, dentists should know the health status of their patients by performing a complete and systematic medical history. Objective: To evaluate the prevalence of medical background (systemic diseases and drug therapy) and identify the level of medical risk of patients seeking dental care by using ASA classification. Material and methods: The questionnaire EMRRH was applied to patients treated by 24 graduated dentists from Universidade Católica Portuguesa between 2006 and 2010. The frequency of diseases, medications and the level of medical risk according to ASA were determined. The tests: Mann-Whitney, T, Kolmogorov-Smirnov, Spearman Rho, Kendall’s tau-b, Levéne, Phi and Cramer’s V were included in the statistical analysis of the collected information. Results: A total number of 796 patients were registered. From these, 54.8% (n=437) had an important medical background for the dental care practice. There were significant differences between the average age of the population with or without former medical problems (p<0,001) and a positive correlation between the number of antecedents and the age of the participant. The analysis of risk according to the ASA classification showed that out of 796 patients, 45.2% (n=359) were within ASA I group; 32.0% (n=255) were classified in group II; 10.9% (n=87) in group III and 11.9% (n=95) in group IV. It was observed that the highest ASA values were associated to the increasing age of the participant. Among the diverse pathologies the one with the highest percentage was hypertension (16.1%) followed by cardiac arrhythmia (10.2%), angina (8.7%) and allergies to drugs or medical devices (8.2%). The prevalence of drug treatments was 35.5%, mostly related to antihypertensive therapy (12.2%). Conclusion: A complete and systematic medical history, combined with the medical risk assessment of each patient, allows the identification of pathophysiological conditions that require modifications of the dental treatment plan to prevent medical emergencies. The questionnaire EMRRH, holds together the valences mentioned therefore it is considered a useful tool for good practice of dentistry.
Introduction: The population seeking dental care has been changing over the recent years. The frequency of treatments in medically compromised patients has increased. To prevent complications, dentists should know the health status of their patients by performing a complete and systematic medical history. Objective: To evaluate the prevalence of medical background (systemic diseases and drug therapy) and identify the level of medical risk of patients seeking dental care by using ASA classification. Material and methods: The questionnaire EMRRH was applied to patients treated by 24 graduated dentists from Universidade Católica Portuguesa between 2006 and 2010. The frequency of diseases, medications and the level of medical risk according to ASA were determined. The tests: Mann-Whitney, T, Kolmogorov-Smirnov, Spearman Rho, Kendall’s tau-b, Levéne, Phi and Cramer’s V were included in the statistical analysis of the collected information. Results: A total number of 796 patients were registered. From these, 54.8% (n=437) had an important medical background for the dental care practice. There were significant differences between the average age of the population with or without former medical problems (p<0,001) and a positive correlation between the number of antecedents and the age of the participant. The analysis of risk according to the ASA classification showed that out of 796 patients, 45.2% (n=359) were within ASA I group; 32.0% (n=255) were classified in group II; 10.9% (n=87) in group III and 11.9% (n=95) in group IV. It was observed that the highest ASA values were associated to the increasing age of the participant. Among the diverse pathologies the one with the highest percentage was hypertension (16.1%) followed by cardiac arrhythmia (10.2%), angina (8.7%) and allergies to drugs or medical devices (8.2%). The prevalence of drug treatments was 35.5%, mostly related to antihypertensive therapy (12.2%). Conclusion: A complete and systematic medical history, combined with the medical risk assessment of each patient, allows the identification of pathophysiological conditions that require modifications of the dental treatment plan to prevent medical emergencies. The questionnaire EMRRH, holds together the valences mentioned therefore it is considered a useful tool for good practice of dentistry.
Description
Keywords
História clínica Antecedentes médicos Estado de saúde Pacientes medicamente comprometidos Tratamentos médico-dentários Emergências médicas Risco médico Medical history Medical background Health status Medically compromised
patients Dental care Medical emergencies Medical risk