Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2016
Third Molar Complications in the Elderly-A Matched-Pairs Analysis.
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Baensch Frederik, Kriwalsky Marcus S, Kleffmann Wiebke, Kunkel Martin
Аннотация
PURPOSE: The aim of this study was to evaluate the perioperative morbidity of third molar (3M) removal in elderly patients in an attempt to estimate the long-term future burden of 3M-related morbidity resulting from the postponement of 3M surgery to old age.
MATERIALS AND METHODS: The study design was a retrospective matched-pair analysis comparing patients at least 65 years old (group A) with a control group of 15- to 20-year-old patients (group B). Age group was the predictor variable in this study. Outcome variables were general health status as defined by the modified Charlson score (MCS) and the American Society of Anesthesiologists (ASA) score, general surgical risks from antithrombotic or antiresorptive medication, and specific local surgical risks and complications.
RESULTS: Patients in group A showed substantially more comorbidities as reflected in significantly higher MCS and ASA scores (P < .001). Older patients more frequently used antithrombotic agents (P < .001), had higher rates of ankylosis (P < .001) and nerve proximity (P < .001), and showed significantly more in intra- and postoperative complications (P < .001), thus resulting in longer operations and a substantially longer hospital stay (P < .001).
CONCLUSION: Within the limits of a non-epidemiologic approach, this study showed a substantially greater burden of morbidity and substantially worse outcome of 3M surgery in older adults compared with young adults. For the medical risks of an aging population, the present data suggest a veritable burst of 3M-associated morbidity when surgery is shifted to late adulthood.
MATERIALS AND METHODS: The study design was a retrospective matched-pair analysis comparing patients at least 65 years old (group A) with a control group of 15- to 20-year-old patients (group B). Age group was the predictor variable in this study. Outcome variables were general health status as defined by the modified Charlson score (MCS) and the American Society of Anesthesiologists (ASA) score, general surgical risks from antithrombotic or antiresorptive medication, and specific local surgical risks and complications.
RESULTS: Patients in group A showed substantially more comorbidities as reflected in significantly higher MCS and ASA scores (P < .001). Older patients more frequently used antithrombotic agents (P < .001), had higher rates of ankylosis (P < .001) and nerve proximity (P < .001), and showed significantly more in intra- and postoperative complications (P < .001), thus resulting in longer operations and a substantially longer hospital stay (P < .001).
CONCLUSION: Within the limits of a non-epidemiologic approach, this study showed a substantially greater burden of morbidity and substantially worse outcome of 3M surgery in older adults compared with young adults. For the medical risks of an aging population, the present data suggest a veritable burst of 3M-associated morbidity when surgery is shifted to late adulthood.