Impact of smoking on perioperative outcomes after major surgery - 18/06/15
, Akshay Sood, M.D. c, 1, Logan Campbell, M.D. c, Victor Kapoor, M.D. c, Deepansh Dalela, M.D. c, Dane E. Klett, M.D. c, Felix K.-H. Chun, M.D. b, Adam S. Kibel, M.D. a, Jesse D. Sammon, D.O. c, Mani Menon, M.D. c, Margit Fisch, M.D. b, Quoc-Dien Trinh, M.D. aAbstract |
Background |
To investigate the impact of smoking on perioperative outcomes in patients undergoing one of the 16 major cardiovascular, orthopedic, or oncologic surgical procedures.
Methods |
We relied on the American College of Surgeons National Surgical Quality Improvement Program database (2005 to 2011). Procedure-specific multivariable logistic regression models assessed the association between smoking status (non, former, or current smokers) and risk of 30-day morbidity and mortality.
Results |
Overall, 141,802 patients were identified. A total of 12.5%, 14.6%, and 14.9% of non, former, and current smokers, respectively, experienced at least one complication (P < .001). In multivariable models, current smokers had higher odds of overall, pulmonary, wound, and septic/shock complications following most cardiovascular and oncologic surgeries compared with nonsmokers. The odds of experiencing such adverse outcomes were significantly lower in former smokers compared with current smokers, but still higher compared with nonsmokers.
Conclusions |
The effect of smoking on perioperative outcomes is procedure dependent. Current and, even though mitigated, former smoking negatively influence outcomes following cardiovascular or oncologic procedures. Patients undergoing major procedures should be encouraged to discontinue tobacco smoking to achieve optimal procedural outcomes.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The impact of smoking on perioperative outcomes is procedure dependent. |
• | Current smoking especially negatively influences outcomes following cardiovascular or oncologic procedures. |
• | Former smokers had less adverse outcomes compared with current smokers, but still more compared with nonsmokers. |
• | Patients undergoing major procedures should be encouraged to discontinue tobacco smoking to achieve optimal procedural outcomes. |
Keywords : Smoking, Surgery, Cardiovascular, Oncologic, Orthopedic, Perioperative outcomes
Plan
| The authors declare no conflicts of interest. |
|
| Author contributions: All authors have directly participated in the planning, execution, or analysis of the study. In addition, they have read and approved the final version submitted. The contents of this manuscript have not been copyrighted or published previously and are not now under consideration for publication elsewhere. They will not be copyrighted, submitted, or published elsewhere while acceptance by The American Journal of Surgery is under consideration. There are no directly related manuscripts or abstracts, published or unpublished, by any authors of this article. If accepted, it will not be published elsewhere including electronically in the same form, in English or in any other language, without the written consent of the copyright holder. |
Vol 210 - N° 2
P. 221 - août 2015 Retour au numéro
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