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Comorbidities in Patients Requiring Dentoalveolar Surgery in Day Care Procedures in Two Different Hospitals: A Comparative Study

Background: This study was performed to determine any management variations in subset of patients admitted to the two different hospitals and also to assess the prevalence and type of comorbidities in each group of surgical patients. Methods: Patients who consented to have dentoalveolar surgery in day care facilities from 1st March 2018 to 28th Feb 2019 were included in this study. Basic demographic data was also recorded such as sex, age and type of operation including their co-morbidities including hypertension, diabetes mellitus, hepatitis, anemia, gastrointestinal disorders, cardiac disorders, renal disorders and blood dyscrasias. Results: There were 94 patients in Holroyd and 167 patients in Strathfied Private Hospital enrolled into this study, with more female patients at Holroyd (M:F=44:50) whereas there were more male patients at Strathfield (M:F=90:77). The majority of patients were aged between 11 years and 30 years in both hospitals but there is a statistically significant difference in the age of the patients, with those being admitted to Strathfield being older as compared to Holroyd Private Hospital (P=0.004). There was no statistical difference in the number of co-morbidities for the patients in the two hospitals (P=0.13). The most common co-morbidity in both hospitals was hypertension. Conclusion: To conclude, only half of our maxillofacial patients are healthy, young adults having 4 wisdom teeth extracted. The majority of our patients are suitable to be done in day surgery center. Patients are suitable to be done in a day surgery center. There are no major differences in the patients being admitted to the smaller, peripheral “day” hospital as compared to the larger, better equipped and supervised hospital. Introduction Patients visiting dental office for extraction of teeth may present with different comorbidities, which sometimes may be unknown to them, or they may be on a complex range of medications for their medical conditions [1,2]. The aim of providing dental treatment is to provide safe and effective management without causing any medical emergency [3]. Dental treatment may sometimes be modified according to the comorbidity of the patient, and sometimes consultation with the medical specialist may be needed. Proper medical history taking is the key to safe patient management [4]. Moreover, modifications of dental management due to compromising medical conditions are necessary to provide better and safer oral care for patients [5]. Dentoalveloar surgery especially the surgical extraction of teeth is one the commonest types of surgery performed in Australia. Our surgical and anesthetic team performs this type of surgery at two locations: Strathfield Private Hospital and Holroyd Private Hospital. These two hospitals vary in their location as well as their facilities. Strathfield Private Hospital is a multispeciality teaching hospital with Cardiac and Intensive Care Unit. Holryod Private Hospital is a day care hospital with geriatric rehabilitation unit. Dentoalveolar patients have always been thought to comprise of young, healthy individuals with very few co-morbidities [6,7]. To substantiate these views, this study was performed to determine any differences in subset of patients admitted to the two different hospitals and also to assess the prevalence and type of co-morbidities in each group of surgical patients. Patrick Chung1 and Dhanrajani P2* 1Department of Oral Surgery, Concord Repatriation General Hospital, Australia 2Department of Oral Surgery, HCF Dental Centre, Australia Dhanrajani P, et al., World Journal of Oral and Maxillofacial Surgery Remedy Publications LLC. 2019 | Volume 2 | Issue 3 | Article 1031 2 Material and Methods This study was conducted at two different hospitals, Strathfield and Holroyd Private Hospital, Sydney, Australia. Holroyd Private Hospital being a free-standing basic district hospital with no resident on duty and no Intensive Care Unit, whereas Strathfield Private Hospital has multispecialty including ICU, resident on duty and cardiology support and is more centrally located. All patients who consented to have dentoalveolar surgery in day care facilities from 1st March 2018 to 28th Feb 2019 were included in this study. The patient’s medical and drug history was recorded to find out the prevalence of different medical conditions including hypertension, diabetes mellitus, hepatitis, anemia, gastrointestinal disorders, cardiac disorders, renal disorders and blood dyscrasias. Basic demographic data was also recorded such as sex, age and type of operation. Results There were 94 patients in Holroyd and 167 patients in Strathfield Private Hospital enrolled into this study, with more female patients at Holroyd (M:F=44:50) whereas there were more male patients at Strathfield (M:F=90:77) (Table 1). The majority of patients in both hospitals were having 4 teeth surgically extracted. The majority of patients were aged between 11 years and 30 years in both hospitals but there is a statistically significant difference in the age of the patient being older in Strathfield as compared to Holroyd Private Hospital (P=0.004) using student’s T-Test. Approximately half of the patients in both hospitals had no known co-morbidities. Holroyd was more likely to have patients with just one co-morbidity (33% vs. 21%) whereas Strathfield was more likely to have patients with 3 or more co-morbidities (19% vs. 12%). There was no statistical difference in number of co-morbidities for the patients in the two hospitals (P=0.13). The most common co-morbidity in both hospitals was hypertension. In Holroyd, the next most common co-morbidities were smoking, gastro-esophageal reflux and asthma. In Strathfield, Tuesday (Holroyd hospital) Saturday (Strathfield private hospital) Total number of lists 23 28 Total number of patients 94 167