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侵入性牙科手术后感染性心内膜炎的风险:一项系统评价和荟萃分析。

Risk of Infective Endocarditis Following Invasive Dental Procedures: A Systematic Review and Meta-Analysis.

作者信息

Kussainova Zhumakyz, Kulmaganbetov Mukhit, Abiltayev Askar, Bulegenov Tolkyn, Salikhanov Islam

机构信息

Department of Public Health, Semey State Medical University, Semey, Kazakhstan.

Centre for Eye and Vision Research Limited (CEVR), Hong Kong, Hong Kong SAR, China.

出版信息

Public Health Rev. 2025 Jan 8;45:1607684. doi: 10.3389/phrs.2024.1607684. eCollection 2024.

DOI:10.3389/phrs.2024.1607684
PMID:39840023
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11750435/
Abstract

OBJECTIVES

This systematic review and meta-analysis aimed to synthesize evidence and determine the association between IE and dental procedures, including invasive and non-invasive procedures.

METHODS

We conducted a systematic search of PubMed, Google Scholar, and Cochrane databases for studies involving procedures such as tooth extraction, scaling, endodontic treatment, oral surgery, and periodontal treatment involving individuals aged ≥15 years. The primary outcome was the incidence of IE following these procedures.

RESULTS

An association was found between IE and invasive dental procedures (OR 1.49, 95% CI 1.25-1.76; p < 0.00001). Subgroup analysis showed an increased risk of IE following tooth extraction (OR 2.73, 95% CI 1.46-5.11; p = 0.002) and oral surgery (OR 6.33, 95% CI 2.43-16.49; p = 0.0002) in high-risk patients.

CONCLUSION

Our study found a strong association between invasive dental procedures and increased IE risk, particularly for tooth extraction and oral surgery in high-risk individuals.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023488546, Identifier CRD42023488546.

摘要

目的

本系统评价和荟萃分析旨在综合证据,确定感染性心内膜炎(IE)与牙科手术之间的关联,包括侵入性和非侵入性手术。

方法

我们对PubMed、谷歌学术和Cochrane数据库进行了系统检索,以查找涉及年龄≥15岁个体的拔牙、洗牙、牙髓治疗、口腔外科手术和牙周治疗等手术的研究。主要结局是这些手术后IE的发生率。

结果

发现IE与侵入性牙科手术之间存在关联(比值比[OR]1.49,95%置信区间[CI]1.25 - 1.76;p < 0.00001)。亚组分析显示,高危患者拔牙(OR 2.73,95% CI 1.46 - 5.11;p = 0.002)和口腔外科手术后IE风险增加(OR 6.33,95% CI 2.43 - 16.49;p = 0.0002)。

结论

我们的研究发现侵入性牙科手术与IE风险增加之间存在密切关联,特别是高危个体的拔牙和口腔外科手术。

系统评价注册

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023488546,标识符CRD42023488546。

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本文引用的文献

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2
Prophylactic antibiotic use for infective endocarditis: a systematic review and meta-analysis.预防感染性心内膜炎的抗生素使用:系统评价和荟萃分析。
BMJ Open. 2023 Aug 22;13(8):e077026. doi: 10.1136/bmjopen-2023-077026.
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Endocarditis, invasive dental procedures, and antibiotic prophylaxis efficacy in US Medicaid patients.美国医疗补助计划患者的心内膜炎、侵入性牙科手术及抗生素预防效果
Oral Dis. 2024 Apr;30(3):1591-1605. doi: 10.1111/odi.14585. Epub 2023 Apr 27.
4
Bacteremia following different oral procedures: Systematic review and meta-analysis.不同口腔操作后菌血症:系统评价和荟萃分析。
Oral Dis. 2024 Apr;30(3):846-854. doi: 10.1111/odi.14531. Epub 2023 Mar 29.
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Trends in the incidence and mortality of infective endocarditis in high-income countries between 1990 and 2019.1990年至2019年期间高收入国家感染性心内膜炎的发病率和死亡率趋势。
Int J Cardiol. 2023 Jan 15;371:441-451. doi: 10.1016/j.ijcard.2022.09.061. Epub 2022 Sep 28.
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