Tobacco dependence in surgical patients

Warner, David O.

doi:10.1097/aco.0b013e3280c60c3b

Cited by 38 publications

(31 citation statements)

References 40 publications

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“…Covariates included age, race and marital status from SHEP, disability due to military service from NPCD, and time from AUDIT-C to surgery. Cigarette smoking status in the past year, 36 the American Society of Anesthesiologists classification (ASA class) documented by anesthesiologists, and the surgical facility were obtained from VASQIP. Additional covariates were selected from 45 pre-operative measures collected by VASQIP that have demonstrated superiority over other measures for surgical riskadjustment.…”

Section: Methodsmentioning

confidence: 99%

Alcohol Screening and Risk of Postoperative Complications in Male VA Patients Undergoing Major Non-cardiac Surgery

et al. 2010

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Section: Methodsmentioning

confidence: 99%

Alcohol Screening and Risk of Postoperative Complications in Male VA Patients Undergoing Major Non-cardiac Surgery

et al. 2010

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“…Smoking is associated with increased postoperative morbidity and mortality. [1][2][3] This is a major concern as up to 20% of surgical patients are smokers. 4,5 A recent large observational study of non-cardiac surgical patients reported that smoking is associated with a 38% increase in the risk of perioperative death and a 30-109% increase in the risk of serious postoperative complications, depending on the type of complication.…”

Section: Résumémentioning

confidence: 99%

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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“…Group for number of cigarettes smoked/day TLIF TS Fig. 2 Dose-response relationship between group for number of cigarettes smoked and the reduction in pain intensity (worst of leg pain or back pain)) from preoperatively to 24 months FU (note, there are a number of overlapping points and hence the number of points shown does not equal the total number of data points contributing to the analysis) In addition to the higher perioperative risks [27], higher wound-related complications, and higher rate of non-union associated with smoking, even poorer results in terms of patient-rated outcome should be expected if TS is chosen as the fusion technique in smokers.…”

Section: Discussionmentioning

confidence: 99%

Should smoking habit dictate the fusion technique?

2010

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The aim of this study was to evaluate the influence of smoking on the outcome of patients undergoing surgery for degenerative spinal diseases, and to examine whether smoking had a differential impact on outcome, depending on the fusion technique used. The cohort included 120 patients treated with two different fusion techniques (translaminar screw fixation and TLIF). They were categorised with regard to their smoking habits at the time of surgery and completed the Core Outcome Measures Index at baseline and follow-up (FU) (3, 12 and 24 months FU); at FU they also rated the global outcome of surgery. The distribution of smokers was comparable in the two groups. For the TS group, the greater the number of cigarettes smoked, the less the reduction in pain intensity from pre-op to 24 months FU; the relationship was not significant for the TLIF group. The percentage of good global outcomes declined with time in the TS smokers such that by 24 months FU, there was a significant difference between TS smokers and TS-non-smokers. No such difference between smokers and non-smokers was evident in the TLIF group at any FU time. In conclusion, the TS technique was more vulnerable to the effects of smoking than was TLIF: possibly the more extensive stabilisation of the 360°fusion renders the environment less susceptible to the detrimental effects on bony fusion of cigarette smoking.

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Tobacco dependence in surgical patients

Cited by 38 publications

References 40 publications

Alcohol Screening and Risk of Postoperative Complications in Male VA Patients Undergoing Major Non-cardiac Surgery

Alcohol Screening and Risk of Postoperative Complications in Male VA Patients Undergoing Major Non-cardiac Surgery

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

Should smoking habit dictate the fusion technique?

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