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    Adverse effects of smoking on postoperative outcomes in cancer patients

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    Authors
    Gajdos, Csaba
    Hawn, Mary T.
    Campagna, Elizabeth J.
    Henderson, William G.
    Singh, Jasvinder A.
    Houston, Thomas K.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2012-05-01
    Keywords
    Aged
    Cardiovascular Diseases
    Causality
    Comorbidity
    Female
    Gastrointestinal Neoplasms
    Humans
    Incidence
    Length of Stay
    Lung Diseases
    Male
    Middle Aged
    Odds Ratio
    Postoperative Complications
    Postoperative Period
    Preoperative Care
    Risk Factors
    Smoking
    Smoking Cessation
    Surgical Wound Infection
    Survival Rate
    Urologic Diseases
    Health Services Research
    Neoplasms
    Oncology
    Substance Abuse and Addiction
    Surgery
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    Link to Full Text
    http://dx.doi.org/10.1245/s10434-011-2128-y
    Abstract
    BACKGROUND: The possible negative effects of smoking on postoperative outcomes have not been well studied in cancer patients. METHODS: We used the VA Surgical Quality Improvement Program (VASQIP) database for the years 2002-2008, which assesses preoperative risk factors and postoperative outcomes for patients undergoing major surgery within the VA healthcare system. RESULTS: Compared with never smokers, prior smokers and current smokers with GI malignancies were significantly more likely to have surgical site infection (SSI) (odds ratio [OR], 1.25; 95% confidence interval [95% CI], 1.09-1.44) (OR, 1.20; 95% CI, 1.05-1.38), combined pulmonary complications (combined pulmonary outcome [CPO]: pneumonia, failure to wean from ventilator, reintubation) (OR, 1.60; 95% CI, 1.38-1.87) (OR, 1.96; 95% CI, 1.68-2.29), and return to the operating room (OR, 1.20; 95% CI, 1.03-1.39) (OR, 1.31; 95% CI, 1.13-1.53), respectively. Both prior and current smokers had a significantly higher mortality at 30 days (OR, 1.50; 95% CI, 1.19-1.89) (OR, 1.41; 95% CI, 1.08-1.82) and 1 year (OR, 1.22; 95% CI, 1.08-1.38) (OR, 1.62; 95% CI, 1.43-1.85). Thoracic surgery patients who were current smokers were more likely to develop CPO (OR, 1.62; 95% CI, 1.25-2.11) and mortality within 1 year (OR, 1.50; 95% CI, 1.17-1.92) compared with nonsmokers, but SSI rates were not affected by smoking status. Current smokers had a significant increase in postsurgical length of stay (overall 4.3% [P < .001], GI 4.7% [P = .003], thoracic 9.0% [P < .001]) compared with prior smokers. CONCLUSIONS: Prior and current smoking status is a significant risk factor for major postoperative complications and mortality following GI cancer and thoracic operations in veterans. Smoking cessation should be encouraged prior to all major cancer surgery in the VA population to decrease postoperative complications and length of stay.
    Source
    Ann Surg Oncol. 2012 May;19(5):1430-8. Epub 2011 Nov 8. Link to article on publisher's site
    DOI
    10.1245/s10434-011-2128-y
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46576
    PubMed ID
    22065194
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1245/s10434-011-2128-y
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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