MEDICAL RISK CLASSIFICATION OF DENTAL PATIENTS IN THE NETHERLANDS

This study centers on the general health of dental patients, evaluated on the basis of the physical status classification system of the Amer ican Society of Anesthesiologists (ASA). A total of 4,087 patients com pleted a risk-related, patient-administered questionnaire. On the basi s of their medical data, a computerized ASA classification was determi ned 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. A fter verification and/or consultation with the physician, the dentist also determined the ASA class, and this was compared with the computer ized outcome, The agreement expressed as a kappa value was 0.64; the c omputer result generally placed the patient in a higher category of me dical risk. The computer-determined ASA classes differed among the var ious dental practices (chi(2)=262.9; df= 138; P<.01). It is possible t o estimate the risk class of dental patients on the basis of standardi zed medical information only; however, the definitive ASA class can on ly be determined after verification of the patient's reply or, in some cases, after consultation with a physician.