Comparative study of postoperative morbidity in dental treatment under general anesthesia in pediatric patients with and without an underlying disease.

OBJECTIVES: To identify and quantify the variables and their influence on postoperative morbidity in dental treatment under general anesthesia (GA) in pediatric patients with and without an underlying disease. METHODS: A prospective, descriptive, and comparative analysis was conducted of healthy (n = 49) and disabled/medically compromised (n = 81) children treated under GA. Intra-/post-surgical, clinical epidemiology, technical, care-related, and pharmacologic data were gathered, as were postoperative complications. RESULTS: The average age of ASA I patients (6.7 ± 4.4 years) was younger than that of ASA II-III patients (9.0 ± 4.5 years). Average hospitalization time was 4.27 ± 6.5 h in ASA I and 7.41 ± 6.8 h in ASA II-III. Significant differences were found between the two groups in fillings, pulpotomies, oral surgery, and scaling. Postoperative morbidity in ASA I and ASA II-III was similar both in frequency and severity and decreased during the first 72 h. The most common complication in both groups was toothache. CONCLUSION: Postoperative morbidity is high after dental treatment under GA, but it is not higher in disabled/medically compromised patients.

[Characteristics of avoidable hospitalization in Spain]. / Características de la hospitalización evitable en España.

BACKGROUND AND OBJECTIVE: Hospitalizations that could have been prevented with a timely and effective ambulatory care are known as avoidable hospitalizations (AH). The measure of AH is an indicator of the quality of primary health care centers. The objective of this study was to determine the factors that influence the level of AH at the Spanish public hospitals. MATERIAL AND METHOD: We identified the characteristics of hospitalised patient as AH. We studied the total hospitalizations in public hospitals of Spain in 2000 related to AH. RESULTS: AH admissions were the 15.8% of total in Spanish hospitals and the 16.6% of hospital stays. Patients' mean age was high, 54 years, males (age-adjusted OR = 1.54) with a large length of stay and presurgery stay, higher comorbidity (0.63 [0.8]), public financing, and admission was basically emergency-caused and in high complexity hospitals. There is a direct relationship between frequency of AH and hospital complexity. CONCLUSIONS: The control of AH is very important because its repercussion on the total hospitalary case-mix. We observe an inducing effect of the hospital offer because the hospital capacity increase the number of AH admissions.