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- Shi, Shu Wen, et al.
(författare)
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Influence of local anesthesia on the outcomes of non-surgical periodontal treatment
- 2020
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Ingår i: Chinese Medical Journal. - 0366-6999. ; 133:16, s. 1908-1914
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is limited evidence of the effects of local anesthesia (LA) on outcomes of non-surgical periodontal treatment (NSPT), in particular among the Chinese. This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes. METHODS: Data from periodontal examinations of 3980 patients were used. The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015. Descriptive analyses included changes in probing depth (PD) and the Mazza bleeding index (BI). Two-level (patient and tooth) logistic regression models and three-level (patient, tooth, and site) linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD ≥ 5 mm. Decreases in PD and BI at sites under LA using the initial PD were also compared. RESULTS: A significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia (NLA) group (0.98 vs. 0.54 mm, t = 24.12, P < 0.001). A significantly higher probability of decreases was found in the LA group in BI (percentages of teeth with BI > 1 and BI > 2) for all teeth (16.7% vs. 13.8%, t = 3.75, P < 0.001; 34.7% vs. 28.1%, t = 6.73, P < 0.001) and PD for teeth with PD ≥ 5 mm (32.3% vs. 17.3%, t = 28.48, P < 0.001). The difference in PD between the LA and NLA groups increased as the initial PD increased. The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD < 7 mm; however, it increased to 0.41 to 1.37 mm for sites with a baseline PD ≥ 7 mm. CONCLUSIONS: LA improved the decrease in PD after NSPT. Root debridement at sites with initial PD ≥ 7 mm should be performed under routine LA.
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| 2. |
- Wang, Yufeng, et al.
(författare)
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ABC-AF-Stroke score predicts thromboembolism in non-anticoagulated patients following successful atrial fibrillation ablation : a report from the Chinese Atrial Fibrillation Registry
- 2023
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Ingår i: Chinese Medical Journal. - : Lippincott Williams & Wilkins. - 0366-6999. ; 136:20, s. 2451-2458
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Tidskriftsartikel (refereegranskat)abstract
- Background: The age, biomarkers, and clinical history (ABC)-atrial fibrillation (AF)-Stroke score have been proposed to refinestroke risk stratification, beyond what clinical risk scores such as the CHA2DS2-VASc score can offer. This study aimed toidentify risk factors associated with thromboembolism and evaluate the performance of the ABC-AF-Stroke score in predictingthromboembolism in non-anticoagulated AF patients following successful ablations.Methods: A total of 2692 patients who underwent successful ablations with discontinued anticoagulation after a 3-monthblanking period in the Chinese Atrial Fibrillation Registry (CAFR) between 2013 and 2019 were included. Cox regressionanalysis was conducted to present the association of risk factors with thromboembolism risk. The ABC-AF-Stroke score wasevaluated in terms of discrimination, including concordance index (C-index), net reclassification improvement (NRI) andintegrated discrimination improvement (IDI), clinical utilization by decision curve analysis (DCA), and calibration bycomparing the predicted risk with the observed annualized event rate.Results: After a median follow-up of 3.5 years, 64 patients experienced thromboembolism events. Age, prior history of stroke/transient ischemic attack (TIA), high-sensitivity cardiac troponin T (cTnT-hs), and N-terminal pro-B-type natriuretic peptide(NT-proBNP) were independently associated with thromboembolism risk. The ABC-AF-Stroke score performed statisticallysignificantly better than the CHA2DS2-VASc score in terms of C-index (0.67, 95% confidence interval [CI]: 0.59–0.74 vs. 0.60,95% CI: 0.52–0.67, P = 0.030) and reclassification capacity. The DCA implied that the ABC-AF-Stroke score could identifymore thromboembolism events without increasing the false positive rate compared to the CHA2DS2-VASc score. The calibrationcurve showed that the ABC-AF-Stroke score was well calibrated in this population.Conclusions: In this real-world study enrolling non-anticoagulated AF patients following successful ablations, age, prior historyof stroke/TIA, level of NT-proBNP, and cTnT-hs were independently associated with an increased risk of thromboembolism.The ABC-AF-Stroke score was well-calibrated and statistically significantly outperformed the CHA2DS2-VASc score inpredicting thromboembolism risk.
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