Effect of Smoking on Short-Term Outcome of Patients Undergoing Coronary Artery Bypass Surgery

Al-Sarraf, Nael; Thalib, Lukman; Hughes, Ann Maree; Tolan, Michael; Young, Vincent; McGovern, Eillish

doi:10.1016/j.athoracsur.2008.03.070

Cited by 66 publications

(68 citation statements)

References 24 publications

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“…42,43 Respiratory complications Fifteen studies involving 19,323 patients reported respiratory complications (Table 2, available as electronic supplemental material [ESM]). 12,20,21,[23][24][25][26][27][28][29][30][31][32]40,42 There were four different time points commonly reported by the studies for respiratory complications, i.e., less than two weeks, two to four weeks, more than four weeks, and more than eight weeks of smoking cessation before surgery. Fourteen studies involving 17,160 patients were included in the metaanalyses.…”

Section: Resultsmentioning

confidence: 99%

“…42,43 Both RCTs offered nicotine replacement therapy. 42,43 There were 14 studies from North America, 12,21,23,26,[30][31][32][33][34][35]37,[39][40][41] six from Europe, 22,27,28,38,42,43 four from Asia, 20,25,29,36 and one from Australia. 24 There were more male than female smokers, and smokers were younger than non-smokers or ex-smokers in many of the studies.…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies involving 17,160 patients were included in the metaanalyses. 12,20,21,[23][24][25][26][28][29][30][31][32]40,42 Eight of these studies involving 3,331 patients were prospective. 12,20,21,[23][24][25]42,43 As there was only one study examining the effect of less than or more than 12 weeks cessation, we could not perform a meta-analysis of this time point.…”

Section: Resultsmentioning

confidence: 99%

“…1). There were seven prospective cohort studies, 12,[20][21][22][23][24][25] 16 retrospective cohort studies, [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and two RCTs (Table 1). 42,43 Both RCTs offered nicotine replacement therapy.…”

Section: Resultsmentioning

confidence: 99%

“…The follow-up periods were not specified in 13 studies (Table 1). 12,20,22,[27][28][29][30][33][34][35][36][37][38]40 The outcome assessor for postoperative complications was blinded to the smoking status of the patients in only five of the studies. 12,29,36,42,43 All five studies reporting the source of funding received public funding, 21,24,36,42,43 and the nicotine replacement products were provided by the manufacturers (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis

Wong

Lam

Abrishami

et al. 2011

Can J Anesth/J Can Anesth

328

161

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Purpose The literature was reviewed to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications and to derive the minimum duration of preoperative abstinence from smoking required to reduce such complications in adult surgical patients. Source We searched MEDLINE, EMBASE, Cochrane, and other relevant databases for cohort studies and randomized controlled trials that reported postoperative complications (i.e., respiratory, cardiovascular, woundhealing) and mortality in patients who quit smoking within six months of surgery. Using a random effects model, meta-analyses were conducted to compare the relative risks of complications in ex-smokers with varying intervals of smoking cessation vs the risks in current smokers. Principal findings We included 25 studies. Compared with current smokers, the risk of respiratory complications was similar in smokers who quit less than two or two to four weeks before surgery (risk ratio [RR] 1.20; 95% confidence interval [CI] 0.96 to 1.50 vs RR 1.14; CI 0.90 to 1.45, respectively). Smokers who quit more than four and more than eight weeks before surgery had lower risks of respiratory complications than current smokers (RR 0.77; 95% CI 0.61 to 0.96 and RR 0.53; 95% CI 0.37 to 0.76, respectively). For wound-healing complications, the risk was less in smokers who quit more than three to four weeks before surgery than in current smokers (RR 0.69; 95% CI 0.56 to 0.84). Few studies reported cardiovascular complications and there were few deaths. Conclusion At least four weeks of abstinence from smoking reduces respiratory complications, and abstinence of at least three to four weeks reduces wound-healing complications. Short-term (less than four weeks) smoking cessation does not appear to increase or reduce the risk of postoperative respiratory complications.Author contributions Jean Wong was involved in data abstraction, interpretation of data, drafting and revising, and final approval of the article. David Paul Lam was involved in data abstraction and drafting of the article. Amir Abrishami was involved in drafting and revising the article, data analysis, and interpretation of the data. Matthew Chan revised and approved the final version of the article. Frances Chung was involved in the conception and design, revising, and final approval of the article. (RR: 0,77; IC a`95 %: 0,96 et RR: 0,53; IC a9 5 %: 0,76, respectivement). Concernant les complications lie´es a`la cicatrisation, le risque a e´te´plus faible chez les fumeurs ayant cesse´plus de trois a`quatre semaines avant l'intervention que chez les fumeurs actifs (RR: 0,69; IC a`95%: 0,56-0,84). Peu d'e´tudes ont de´crit des complications cardiovasculaires et il n'y a eu que peu de de´ce`s. Conclusion Un minimum de quatre semaines d'abstinence du tabagisme diminue le risque de complications respiratoires et un minimum de trois a`quatre semaines re´duit le risque de complications lie´es a`la cicatrisation. L'arreˆt à court terme (moins de quatre semaines) du tab...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis

Wong

Lam

Abrishami

et al. 2011

Can J Anesth/J Can Anesth

328

161

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Stopping Smoking Shortly Before Surgery and Postoperative Complications

Myers¹,

Hájek²,

Hinds³

et al. 2011

Arch Intern Med

209

104

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Existing data indicate that the concern that stopping smoking only a few weeks prior to surgery might worsen clinical outcomes is unfounded. Further larger studies would be useful to arrive at a more robust conclusion. Patients should be advised to stop smoking as early as possible, but there is no evidence to suggest that health professionals should not be advising smokers to quit at any time prior to surgery.

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Wound Healing and Infection in Surgery

Sørensen¹

2012

Arch Surg

497

126

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To clarify the evidence on smoking and postoperative healing complications across surgical specialties and to determine the impact of perioperative smoking cessation intervention. Data Sources: Cohort studies and randomized controlled trials. Study Selection: Selected studies were identified through electronic databases (CENTRAL, MEDLINE, and EMBASE) and by hand searching. Data Extraction: Multiple data on study characteristics were extracted. Risk of bias was assessed by means of the Newcastle-Ottawa Scale and Jadad score. Healing outcome was classified as necrosis, healing delay and dehiscence, surgical site infection, wound complications, hernia, and lack of fistula or bone healing. Mantel-Haenszel and inverse variance methods for metaanalysis (fixed-and random-effects models) were used.

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Effect of Smoking on Short-Term Outcome of Patients Undergoing Coronary Artery Bypass Surgery

Cited by 66 publications

References 24 publications

Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis

Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis

Stopping Smoking Shortly Before Surgery and Postoperative Complications

Wound Healing and Infection in Surgery

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