Using Electronic Dental Records to Assess Osteoradionecrosis Risk in Irradiated Head and Neck Cancer
Using Electronic Dental Records to Assess Osteoradionecrosis Risk in Irradiated Head and Neck Cancer
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DOI：
10.1177/23800844221089549
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发表时间：
2022-04-15
影响因子：
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通讯作者：
Walji, M. F.
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文献类型：
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作者：
Saenthaveesuk, P.;Kiat-amnuay, S.;Walji, M. F.
目的：在过去的20年里，研究表明拔牙后颌骨放射性骨坏死（ORNJ）的可能性呈下降趋势。本研究的目的是通过使用患者的电子牙科记录（EDRs）来探讨放射性头颈癌中ORNJ的潜在危险因素。方法：将2010年1月至2020年12月期间诊断为头颈癌并接受放射治疗的患者纳入本回顾性队列分析。显示“头颈癌”、”口腔癌”、“放射疗法”、“辐射”和“口腔并发症”证据的患者图表由查询EDR的信息分析员识别。随后，人工审查图表，并从3个方面评估数据质量：完整性、准确性和一致性。患者、肿瘤、全身状况/药物、口腔状况、治疗/创伤和放射治疗均被归类为潜在危险因素。除辐射相关因素外，我们发现数据质量总体上足以支持研究。多因素Logistic回归分析表明，以下因素在预测放射性头颈部癌发生ORNJ方面具有重要意义：吸烟（比值比[OR]，9.0; 95% CI，1.9 - 43.0; P = 0.006），类固醇使用（OR，6.4; 95%CI，1.3 - 30.8; P = 0.021），口腔健康状况（OR，23.7; 95%CI，2.7 - 211.0; P = 0.005），（OR，3.8; 95%CI，1.0至14.4; P = 0.050）。对EDR数据的10年回顾性分析显示，吸烟、类固醇使用、口腔状况差，和放疗后拔牙都与ORNJ风险增加有关。通过确定基础数据的完整性、准确性和一致性，可以系统地评估EDR数据的质量。特别是与辐射有关的因素记录得很差，这突出表明需要收集这方面的信息或将其纳入EDR。知识转移声明：EDR可用于识别放射性头颈癌中发生ORNJ的风险因素，并可通过纳入风险和并发症考虑因素帮助临床医生选择治疗方法。知识转移声明：EDR可用于识别放射性头颈部癌发生ORNJ的风险因素，并可通过纳入风险和并发症考虑因素帮助临床医生选择治疗方法。
Objective: Over the last 2 decades, investigations have demonstrated a decreased trend in the likelihood of osteoradionecrosis of the jaw (ORNJ) after extraction. The aim of this study was to explore the potential risk factors for ORNJ in irradiated head and neck cancer by using patients' electronic dental records (EDRs).Methods: Patients diagnosed with head and neck cancer who had irradiation between January 2010 and December 2020 were included in this retrospective cohort analysis. Patient charts showing evidence of "head and neck cancer," "oral cancer," "radiotherapy," "radiation," and "oral complication" were identified by an informatics analyst querying the EDR. Subsequently, the charts were manually reviewed, and data quality was assessed on 3 dimensions: completeness, accuracy, and consistency. The patient, tumor, systemic condition/drug, oral condition, treatment/trauma, and radiation were all categorized as potential risk factors.Results: A total of 359 patients were included. With the exception of radiation-related factors, we found that the data quality was generally sufficient to support the research. Multivariate logistic regression analysis demonstrated that the following factors were significant in predicting the occurrence of ORNJ development in irradiated head and neck cancer: smoking (odds ratio [OR], 9.0; 95% CI, 1.9 to 43.0; P = 0.006), steroid use (OR, 6.4; 95% CI, 1.3 to 30.8; P = 0.021), oral health status (OR, 23.7; 95% CI, 2.7 to 211.0; P = 0.005), and postirradiation extraction (OR, 3.8; 95% CI, 1.0 to 14.4; P = 0.050).Conclusions: A 10-y retrospective analysis of data from an EDR revealed that smoking, steroid use, poor oral status, and postirradiation extraction are all factors linked to an increased risk of developing ORNJ. The quality of EDR data may be systematically assessed by determining the completeness, accuracy, and consistency of the underlying data. Radiation-related factors in particular were poorly documented, highlighting the need for collecting or incorporating this information into the EDR. Knowledge Transfer Statement: EDRs can be used to identify risk factors for developing ORNJ in irradiated head and neck cancer and can help clinicians with selecting treatments by incorporating risk and complication considerations. were poorly documented, highlighting the need for collecting or incorporating this information into the EDR.Knowledge Transfer Statement: EDRs can be used to identify risk factors for developing ORNJ in irradiated head and neck cancer and can help clinicians with selecting treatments by incorporating risk and complication considerations.