TY - JOUR
T1 - Association of preoperative smoking with complications following major gastrointestinal surgery
AU - Brajcich, Brian C.
AU - Yuce, Tarik K.
AU - Merkow, Ryan P.
AU - Bilimoria, Karl Y.
AU - McGee, Michael F.
AU - Zhan, Tiannan
AU - Odell, David D.
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/2
Y1 - 2022/2
N2 - 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.
AB - 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.
KW - Digestive system surgical procedures
KW - Elective surgical procedures
KW - Postoperative complications
KW - Smoking
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U2 - 10.1016/j.amjsurg.2021.06.002
DO - 10.1016/j.amjsurg.2021.06.002
M3 - Article
C2 - 34119328
AN - SCOPUS:85107556746
SN - 0002-9610
VL - 223
SP - 312
EP - 317
JO - American journal of surgery
JF - American journal of surgery
IS - 2
ER -