Impact of smoking on perioperative outcomes after major surgery
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Impact of smoking on perioperative outcomes after major surgery. / Schmid, Marianne; Sood, Akshay; Campbell, Logan; Kapoor, Victor; Dalela, Deepansh; Klett, Dane E; Chun, Felix K-H; Kibel, Adam S; Sammon, Jesse D; Menon, Mani; Fisch, Margit; Trinh, Quoc-Dien.
In: AM J SURG, Vol. 210, No. 2, 08.2015, p. 221-229.e6.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research
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TY - JOUR
T1 - Impact of smoking on perioperative outcomes after major surgery
AU - Schmid, Marianne
AU - Sood, Akshay
AU - Campbell, Logan
AU - Kapoor, Victor
AU - Dalela, Deepansh
AU - Klett, Dane E
AU - Chun, Felix K-H
AU - Kibel, Adam S
AU - Sammon, Jesse D
AU - Menon, Mani
AU - Fisch, Margit
AU - Trinh, Quoc-Dien
N1 - Copyright © 2015 Elsevier Inc. All rights reserved.
PY - 2015/8
Y1 - 2015/8
N2 - 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.
AB - 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.
KW - Aged
KW - Cardiovascular Surgical Procedures
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoplasms
KW - Orthopedic Procedures
KW - Postoperative Complications
KW - Smoking
U2 - 10.1016/j.amjsurg.2014.12.045
DO - 10.1016/j.amjsurg.2014.12.045
M3 - SCORING: Journal article
C2 - 25980408
VL - 210
SP - 221-229.e6
JO - AM J SURG
JF - AM J SURG
SN - 0002-9610
IS - 2
ER -