Substance Use Among Iranian Cardiac Surgery Patients and Its Effects on Short-Term Outcome

Abstract

In cardiac surgery patients in northwest Iran, the prevalence of cigarette smoking is relatively low (very low in women), as is alcohol use, compared with Western countries; however, opium use is twice as prevalent. We found higher pulmonary complication rates in men who smoked, but no increase in postoperative cardiopulmonary complications and in-hospital mortality rates in patients who abused opium and consumed alcohol.

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

“…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.…”

“…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.…”

“…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).…”

“…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.…”

“…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. 27 Summary of meta-analyses of respiratory complications The relative risk (RR) of postoperative respiratory complications was higher in those who continued smoking at the time of surgery compared with non-smokers (RR 2.11; 95% CI 1.51 to 2.94; I 2 = 61%; P \ 0.0001).…”