The Attributable Risk of Smoking on Surgical Complications

• DOI: 10.1097/sla.0b013e31822d7f81
• Publication Date: 2011-10-04T22:37:48Z
• Authors: Mary T. Hawn; Thomas K. Houston; Elizabeth J. Camp...; Laura A. Graham; Jasvinder Singh; Michael Bishop; William G. Henderson
• Keywords: Veterans Affairs

This study aimed to assess the attributable risk and potential benefit of smoking cessation on surgical outcomes.Risk reduction with implementation care improvement project process measures has been primary focus for improving outcomes. Little emphasis placed preoperative factor recognition intervention.A retrospective cohort analysis elective operations from 2002 2008 in Veterans Affairs Surgical Quality Improvement Program all specialties was performed. Patients were stratified by current, prior, never smokers. Adjusted complication death calculated using multilevel, multivariable logistic regression.Of 393,794 patients, 135,741 (34.5%) 71,421 (18.1%) 186,632 (47.4%) A total 6225 pneumonias, 11,431 deep superficial surgical-site infections, 2040 thromboembolic events, 1338 myocardial infarctions, 4792 deaths occurred within 30 days surgery. Compared both prior smokers individually controlled patient procedure factors, current had significantly more postoperative pneumonia, infection, (P < 0.001 all). There a dose-dependent increase pulmonary complications based pack-year exposure greater than 20 pack years leading significant smoking-related complications.This is first versus Despite being younger healthier, adverse perioperative particularly respiratory complications. Smoking interventions could potentially reduce occurrence costs events.