Association of preoperative smoking with complications following major gastrointestinal surgery

Brian C. Brajcich*, Tarik K. Yuce, Ryan P. Merkow, Karl Y. Bilimoria, Michael F. McGee, Tiannan Zhan, David D. Odell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Understanding modifiable surgical risk factors is essential for preoperative optimization. We evaluated the association between smoking and complications following major gastrointestinal surgery. Methods: Patients who underwent elective colorectal, pancreatic, gastric, or hepatic procedures were identified in the 2017 ACS NSQIP dataset. The primary outcome was 30-day death or serious morbidity (DSM). Secondary outcomes included pulmonary complications, wound complications, and readmission. Multivariable logistic regression was used to evaluate the association between smoking and these outcomes. Results: A total of 46,921 patients were identified, of whom 7,671 (16.3%) were smokers. Smoking was associated with DSM (23.2% vs. 20.4%, OR 1.15 [1.08–1.23]), wound complications (13.0% vs. 10.4%, OR 1.24 [1.14–1.34]), pulmonary complications (4.9% vs 2.9%, OR 1.93 [1.70–2.20]), and unplanned readmission (12.6% vs. 11%, OR 1.14 [95% CI 1.06–1.23]). Conclusions: Smoking is associated with complications following major gastrointestinal surgery. Patients who smoke should be counseled prior to surgery regarding risks.

Original languageEnglish (US)
JournalAmerican journal of surgery
DOIs
StateAccepted/In press - 2021

Keywords

  • Digestive system surgical procedures
  • Elective surgical procedures
  • Postoperative complications
  • Smoking

ASJC Scopus subject areas

  • Surgery

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