TY - JOUR
T1 - Does Smoking Status Influence Health-Related Quality of Life Outcome Measures in Patients Undergoing ACDF?
AU - Mangan, John J.
AU - Goyal, Dhruv K.C.
AU - Divi, Srikanth N.
AU - Bowles, Daniel R.
AU - Nicholson, Kristen J.
AU - Mujica, Victor E.
AU - Lee, Thomas J.
AU - DePaola, Rosalie V.
AU - Saline, Austin
AU - Fang, Taolin
AU - Galetta, Matthew S.
AU - Kaye, I. David
AU - Kurd, Mark F.
AU - Woods, Barrett I.
AU - Radcliff, Kris E.
AU - Rihn, Jeffery A.
AU - Anderson, D. Greg
AU - Hilibrand, Alan S.
AU - Kepler, Christopher K.
AU - Vaccaro, Alexander R.
AU - Schroeder, Gregory D.
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2021/1
Y1 - 2021/1
N2 - Study design: Retrospective comparative study. Objective: Whereas smoking has been shown to affect the fusion rates for patients undergoing an anterior cervical discectomy and fusion (ACDF), the relationship between smoking and health-related quality of life outcome measurements after an ACDF is less clear. The purpose of this study was to evaluate whether smoking negatively affects patient outcomes after an ACDF for cervical degenerative pathology. Methods: Patients with tumor, trauma, infection, and previous cervical spine surgery and those with less than a year of follow-up were excluded. Smoking status was assessed by self-reported smoking history. Patient outcomes, including Neck Disability Index, Short Form 12 Mental Component Score, Short Form 12 Physical Component Score (PCS-12), Visual Analogue Scale (VAS) arm pain, VAS neck pain, and pseudarthrosis rates were evaluated. Outcomes were compared between smoking groups using multiple linear and logistic regression, controlling for age, sex, and body mass index (BMI), among other factors. A P value <.05 was considered significant. Results: A total of 264 patients were included, with a mean follow-up of 19.8 months, age of 53.1 years, and BMI of 29.6 kg/m2. There were 43 current, 69 former, and 152 nonsmokers in the cohort. At baseline, nonsmokers had higher PCS-12 scores than current smokers (P =.010), lower VAS neck pain than current (P =.035) and former (P =.014) smokers, as well as lower VAS arm pain than former smokers (P =.006). Postoperatively, nonsmokers had higher PCS-12 scores than both current (P =.030) and former smokers (P =.035). Smoking status was not a significant predictor of change in patient outcome in multivariate analysis. Conclusions: Whereas nonsmokers had higher function and lower pain than former or current smokers preoperatively, smoking status overall was not found to be an independent predictor of outcome scores after ACDF. This supports the notion that smoking status alone should not deter patients from undergoing ACDF for cervical degenerative pathology.
AB - Study design: Retrospective comparative study. Objective: Whereas smoking has been shown to affect the fusion rates for patients undergoing an anterior cervical discectomy and fusion (ACDF), the relationship between smoking and health-related quality of life outcome measurements after an ACDF is less clear. The purpose of this study was to evaluate whether smoking negatively affects patient outcomes after an ACDF for cervical degenerative pathology. Methods: Patients with tumor, trauma, infection, and previous cervical spine surgery and those with less than a year of follow-up were excluded. Smoking status was assessed by self-reported smoking history. Patient outcomes, including Neck Disability Index, Short Form 12 Mental Component Score, Short Form 12 Physical Component Score (PCS-12), Visual Analogue Scale (VAS) arm pain, VAS neck pain, and pseudarthrosis rates were evaluated. Outcomes were compared between smoking groups using multiple linear and logistic regression, controlling for age, sex, and body mass index (BMI), among other factors. A P value <.05 was considered significant. Results: A total of 264 patients were included, with a mean follow-up of 19.8 months, age of 53.1 years, and BMI of 29.6 kg/m2. There were 43 current, 69 former, and 152 nonsmokers in the cohort. At baseline, nonsmokers had higher PCS-12 scores than current smokers (P =.010), lower VAS neck pain than current (P =.035) and former (P =.014) smokers, as well as lower VAS arm pain than former smokers (P =.006). Postoperatively, nonsmokers had higher PCS-12 scores than both current (P =.030) and former smokers (P =.035). Smoking status was not a significant predictor of change in patient outcome in multivariate analysis. Conclusions: Whereas nonsmokers had higher function and lower pain than former or current smokers preoperatively, smoking status overall was not found to be an independent predictor of outcome scores after ACDF. This supports the notion that smoking status alone should not deter patients from undergoing ACDF for cervical degenerative pathology.
KW - Short Form-12 health survey
KW - Visual Analogue Score
KW - anterior cervical discectomy and fusion
KW - arm pain
KW - neck disability index
KW - neck pain
KW - patient reported outcome measurements
KW - smoking
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U2 - 10.1177/2192568219890292
DO - 10.1177/2192568219890292
M3 - Article
C2 - 32875848
AN - SCOPUS:85097418657
SN - 2192-5682
VL - 11
SP - 50
EP - 56
JO - Global Spine Journal
JF - Global Spine Journal
IS - 1
ER -