The effect of smoking on 30-day outcomes in elective hernia repair

John O. DeLancey, Eddie Blay, D. Brock Hewitt, Kathryn Engelhardt, Karl Y Bilimoria, Jane Louise Holl, David Duston Odell, Anthony D Yang, Jonah James Stulberg

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Adverse postoperative outcomes related to smoking are well established, yet current smokers continue to be offered elective surgery in the US. It is unknown whether patients undergoing low-risk, elective procedures, who actively smoke experience increased risk of complications. We sought to determine the increased burden of complications following elective hernia repair procedures in patients identified as current smokers. Methods: We identified patients undergoing elective incisional, inguinal, umbilical, or ventral hernia repair from 2011 to 2014 using the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) database. Multivariable logistic regression analysis was used to examine the association between current smoking and 30-day postoperative outcomes, adjusting for demographics and comorbidities. Results: Of 220,629 patients who underwent elective hernia repair, 40,446 (18.3%) self-identified as current smokers within the past 12 months. Current smokers experienced an increased likelihood (Odds Ratio [95% Confidence interval]) of reoperation (OR 1.23 [95% CI 1.11–1.36]), readmission (OR 1.24 [95% CI 1.16–1.32]), and death (OR 1.53 [95% CI 1.06–2.22]). Furthermore, smokers experienced an increased risk of postoperative pulmonary, infectious, and wound complications, but there was no increased risk of requiring transfusion or of postoperative cardiac or thromboembolic events. Conclusions: Current smokers were more likely to experience serious postoperative complications within 30 days. Given the volume of elective hernia surgery performed in the US, encouraging smoking cessation prior to offering elective repair could reduce postoperative complications, reoperation, readmission, and mortality.

Original languageEnglish (US)
Pages (from-to)471-474
Number of pages4
JournalAmerican journal of surgery
Volume216
Issue number3
DOIs
StatePublished - Sep 1 2018

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Herniorrhaphy
Smoking
Reoperation
Ventral Hernia
Umbilical Hernia
Inguinal Hernia
Smoking Cessation
Hernia
Quality Improvement
Smoke
Comorbidity
Logistic Models
Odds Ratio
Regression Analysis
Demography
Databases
Confidence Intervals
Lung
Mortality
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "The effect of smoking on 30-day outcomes in elective hernia repair",
abstract = "Background: Adverse postoperative outcomes related to smoking are well established, yet current smokers continue to be offered elective surgery in the US. It is unknown whether patients undergoing low-risk, elective procedures, who actively smoke experience increased risk of complications. We sought to determine the increased burden of complications following elective hernia repair procedures in patients identified as current smokers. Methods: We identified patients undergoing elective incisional, inguinal, umbilical, or ventral hernia repair from 2011 to 2014 using the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) database. Multivariable logistic regression analysis was used to examine the association between current smoking and 30-day postoperative outcomes, adjusting for demographics and comorbidities. Results: Of 220,629 patients who underwent elective hernia repair, 40,446 (18.3{\%}) self-identified as current smokers within the past 12 months. Current smokers experienced an increased likelihood (Odds Ratio [95{\%} Confidence interval]) of reoperation (OR 1.23 [95{\%} CI 1.11–1.36]), readmission (OR 1.24 [95{\%} CI 1.16–1.32]), and death (OR 1.53 [95{\%} CI 1.06–2.22]). Furthermore, smokers experienced an increased risk of postoperative pulmonary, infectious, and wound complications, but there was no increased risk of requiring transfusion or of postoperative cardiac or thromboembolic events. Conclusions: Current smokers were more likely to experience serious postoperative complications within 30 days. Given the volume of elective hernia surgery performed in the US, encouraging smoking cessation prior to offering elective repair could reduce postoperative complications, reoperation, readmission, and mortality.",
author = "DeLancey, {John O.} and Eddie Blay and Hewitt, {D. Brock} and Kathryn Engelhardt and Bilimoria, {Karl Y} and Holl, {Jane Louise} and Odell, {David Duston} and Yang, {Anthony D} and Stulberg, {Jonah James}",
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The effect of smoking on 30-day outcomes in elective hernia repair. / DeLancey, John O.; Blay, Eddie; Hewitt, D. Brock; Engelhardt, Kathryn; Bilimoria, Karl Y; Holl, Jane Louise; Odell, David Duston; Yang, Anthony D; Stulberg, Jonah James.

In: American journal of surgery, Vol. 216, No. 3, 01.09.2018, p. 471-474.

Research output: Contribution to journalArticle

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T1 - The effect of smoking on 30-day outcomes in elective hernia repair

AU - DeLancey, John O.

AU - Blay, Eddie

AU - Hewitt, D. Brock

AU - Engelhardt, Kathryn

AU - Bilimoria, Karl Y

AU - Holl, Jane Louise

AU - Odell, David Duston

AU - Yang, Anthony D

AU - Stulberg, Jonah James

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Background: Adverse postoperative outcomes related to smoking are well established, yet current smokers continue to be offered elective surgery in the US. It is unknown whether patients undergoing low-risk, elective procedures, who actively smoke experience increased risk of complications. We sought to determine the increased burden of complications following elective hernia repair procedures in patients identified as current smokers. Methods: We identified patients undergoing elective incisional, inguinal, umbilical, or ventral hernia repair from 2011 to 2014 using the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) database. Multivariable logistic regression analysis was used to examine the association between current smoking and 30-day postoperative outcomes, adjusting for demographics and comorbidities. Results: Of 220,629 patients who underwent elective hernia repair, 40,446 (18.3%) self-identified as current smokers within the past 12 months. Current smokers experienced an increased likelihood (Odds Ratio [95% Confidence interval]) of reoperation (OR 1.23 [95% CI 1.11–1.36]), readmission (OR 1.24 [95% CI 1.16–1.32]), and death (OR 1.53 [95% CI 1.06–2.22]). Furthermore, smokers experienced an increased risk of postoperative pulmonary, infectious, and wound complications, but there was no increased risk of requiring transfusion or of postoperative cardiac or thromboembolic events. Conclusions: Current smokers were more likely to experience serious postoperative complications within 30 days. Given the volume of elective hernia surgery performed in the US, encouraging smoking cessation prior to offering elective repair could reduce postoperative complications, reoperation, readmission, and mortality.

AB - Background: Adverse postoperative outcomes related to smoking are well established, yet current smokers continue to be offered elective surgery in the US. It is unknown whether patients undergoing low-risk, elective procedures, who actively smoke experience increased risk of complications. We sought to determine the increased burden of complications following elective hernia repair procedures in patients identified as current smokers. Methods: We identified patients undergoing elective incisional, inguinal, umbilical, or ventral hernia repair from 2011 to 2014 using the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) database. Multivariable logistic regression analysis was used to examine the association between current smoking and 30-day postoperative outcomes, adjusting for demographics and comorbidities. Results: Of 220,629 patients who underwent elective hernia repair, 40,446 (18.3%) self-identified as current smokers within the past 12 months. Current smokers experienced an increased likelihood (Odds Ratio [95% Confidence interval]) of reoperation (OR 1.23 [95% CI 1.11–1.36]), readmission (OR 1.24 [95% CI 1.16–1.32]), and death (OR 1.53 [95% CI 1.06–2.22]). Furthermore, smokers experienced an increased risk of postoperative pulmonary, infectious, and wound complications, but there was no increased risk of requiring transfusion or of postoperative cardiac or thromboembolic events. Conclusions: Current smokers were more likely to experience serious postoperative complications within 30 days. Given the volume of elective hernia surgery performed in the US, encouraging smoking cessation prior to offering elective repair could reduce postoperative complications, reoperation, readmission, and mortality.

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