Medical Risk Classification of Dental Patients in the Netherlands

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Abstract
This study centers on the general health of dental patients, evaluated on the basis of the physical status classification system of the American Society of Anesthesiologists (ASA). A total of 4,087 patients completed a risk-related, patient-administered questionnaire. On the basis of their medical data, a computerized ASA classification was determined for each patient: 63.3 percent were in ASA class I, 25.7 percent in class II, 8.9 percent in class III, and 2.1 percent in class IV. After verification and/or consultation with the physician, the dentist also determined the ASA class, and this was compared with the computerized outcome. The agreement expressed as a kappa value was 0.64; the computer result generally placed the patient in a higher category of medical risk. The computer-determined ASA classes differed among the various dental practices (chi 2 = 262.9; df = 138; P < .01). It is possible to estimate the risk class of dental patients on the basis of standardized medical information only; however, the definitive ASA class can only be determined after verification of the patient's reply or, in some cases, after consultation with a physician.