Post-Operative Complications and Readmissions Associated with Smoking Following Bariatric Surgery

Tarik K. Yuce, Rhami Khorfan, Nathaniel J. Soper, Eric S. Hungness, Alexander P. Nagle, Ezra N. Teitelbaum, Karl Y. Bilimoria, David D. Odell*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. We describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent laparoscopic sleeve gastrectomy and Roux-En-Y gastric bypass from 2012 to 2017. Patient outcomes were compared based on smoking status. Primary outcomes included 30-day readmission and death or serious morbidity. Secondary outcomes included wound and respiratory complications. Multivariable logistic regression was used to determine the association between smoking status and measured outcomes. Results: Of the 133,417 patients who underwent bariatric surgery, 12,424 (9.3%) were smokers. Smokers more frequently experienced readmission (4.9% v 4.1%, p < 0.001), death or serious morbidity (3.8% v 3.4%, p = 0.019), wound complications (2% v 1.4%, p < 0.001), and respiratory complications (0.8% v 0.5%, p < 0.001). The likelihood of death or serious morbidity (OR 1.13, 95% CI 1.01–1.26), readmission (OR 1.21, 95% CI 1.10–1.33), wound (OR 1.44, 95% CI 1.24–1.68), and respiratory complications (OR 1.69, 95% CI 1.34–2.14) were greater in smokers. The adjusted ORs remained significant on subgroup analysis of laparoscopic sleeve gastrectomy and Roux-En-Y gastric bypass patients, with the exception of death or serious morbidity in laparoscopic Roux-En-Y gastric bypass (OR 1.04, 95% CI 0.89–1.24). Conclusions: Smokers undergoing bariatric surgery experience significantly worse 30-day outcomes when compared with non-smokers. There should be a continued emphasis on perioperative smoking cessation for patients being evaluated for bariatric surgery.

Original languageEnglish (US)
Pages (from-to)525-530
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2020

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Keywords

  • Bariatric surgery
  • Outcomes
  • Smoking

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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