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dc.contributor.authorHoel, Andrew W.
dc.contributor.authorNolan, Brian W.
dc.contributor.authorGoodney, Philip P.
dc.contributor.authorZhao, Yuanyuan
dc.contributor.authorSchanzer, Andres
dc.contributor.authorStanley, Andrew C.
dc.contributor.authorEldrup-Jorgensen, Jens
dc.contributor.authorCronenwett, Jack L.
dc.contributor.authorVascular Study Group of New England
dc.date2022-08-11T08:10:58.000
dc.date.accessioned2022-08-23T17:26:45Z
dc.date.available2022-08-23T17:26:45Z
dc.date.issued2013-05-01
dc.date.submitted2014-02-12
dc.identifier.citation<p> Hoel AW, Nolan BW, Goodney PP, Zhao Y, Schanzer A, Stanley AC, Eldrup-Jorgensen J, Cronenwett JL; Vascular Study Group of New England. Variation in smoking cessation after vascular operations. J Vasc Surg. 2013 May;57(5):1338-44; quiz 1344.e1-4. doi:10.1016/j.jvs.2012.10.130. <a href="http://dx.doi.org/10.1016/j.jvs.2012.10.130" target="_blank">Link to article on publisher's site</a></p>
dc.identifier.issn0741-5214 (Linking)
dc.identifier.doi10.1016/j.jvs.2012.10.130
dc.identifier.pmid23375433
dc.identifier.urihttp://hdl.handle.net/20.500.14038/49710
dc.description.abstractOBJECTIVE: Smoking is the most important modifiable risk factor for patients with vascular disease. The purpose of this study was to examine smoking cessation rates after vascular procedures and delineate factors predictive of postoperative smoking cessation. METHODS: The Vascular Study Group of New England registry was used to analyze smoking status preoperatively and at 1 year after carotid endarterectomy, carotid artery stenting, lower extremity bypass, and open and endovascular abdominal aortic aneurysm repair between 2003 and 2009. Of 10,734 surviving patients after one of these procedures, 1755 (16%) were lost to follow-up and 1172 (11%) lacked documentation of their smoking status at follow-up. The remaining 7807 patients (73%) were available for analysis. Patient factors independently associated with smoking cessation were determined using multivariate analysis. The relative contribution of patient and procedure factors including treatment center were measured by chi-pie analysis. Variation between treatment centers was further evaluated by calculating expected rates of cessation and by analysis of means. Vascular Study Group of New England surgeons were surveyed regarding their smoking cessation techniques (85% response rate). RESULTS: At the time of their procedure, 2606 of 7807 patients (33%) were self-reported current smokers. Of these, 1177 (45%) quit within the first year of surgery, with significant variation by procedure type (open abdominal aortic aneurysm repair, 50%; endovascular repair, 49%; lower extremity bypass, 46%; carotid endarterectomy, 43%; carotid artery stenting, 27%). In addition to higher smoking cessation rates with more invasive procedures, age >70 years (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.30-2.76; P < .001) and dialysis dependence (OR, 2.38; 95% CI, 1.04-5.43; P = .04) were independently associated with smoking cessation, whereas hypertension (OR, 1.23; 95% CI, 1.00-1.51; P = .051) demonstrated a trend toward significance. Treatment center was the greatest contributor to smoking cessation, and there was broad variation in smoking cessation rates, from 28% to 62%, between treatment centers. Cessation rates were higher than expected in three centers and significantly lower than expected in two centers. Among survey respondents, 78% offered pharmacologic therapy or referral to a smoking cessation specialist, or both. The smoking cessation rate for patients of these surgeons was 48% compared with 33% in those who did not offer medications or referral (P < .001). CONCLUSIONS: Patients frequently quit smoking after vascular surgery, and multiple patient-related and procedure-related factors contribute to cessation. However, we note significant influence of treatment center on cessation as well as broad variation in cessation rates between treatment centers. This variation indicates an opportunity for vascular surgeons to impact smoking cessation at the time of surgery. rights reserved.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=23375433&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.jvs.2012.10.130
dc.subjectAged
dc.subjectAngioplasty
dc.subjectAortic Aneurysm, Abdominal
dc.subjectBlood Vessel Prosthesis Implantation
dc.subjectCarotid Artery Diseases
dc.subjectChi-Square Distribution
dc.subjectEndarterectomy, Carotid
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMultivariate Analysis
dc.subjectNew England
dc.subjectOdds Ratio
dc.subjectPeripheral Vascular Diseases
dc.subject*Physician's Practice Patterns
dc.subjectPostoperative Care
dc.subjectPrevalence
dc.subjectRegistries
dc.subjectRisk Factors
dc.subject*Risk Reduction Behavior
dc.subjectSmoking
dc.subject*Smoking Cessation
dc.subjectStents
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectVascular Diseases
dc.subject*Vascular Surgical Procedures
dc.subjectSurgery
dc.titleVariation in smoking cessation after vascular operations
dc.typeJournal Article
dc.source.journaltitleJournal of vascular surgery
dc.source.volume57
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/surgery_pp/137
dc.identifier.contextkey5111954
html.description.abstract<p>OBJECTIVE: Smoking is the most important modifiable risk factor for patients with vascular disease. The purpose of this study was to examine smoking cessation rates after vascular procedures and delineate factors predictive of postoperative smoking cessation.</p> <p>METHODS: The Vascular Study Group of New England registry was used to analyze smoking status preoperatively and at 1 year after carotid endarterectomy, carotid artery stenting, lower extremity bypass, and open and endovascular abdominal aortic aneurysm repair between 2003 and 2009. Of 10,734 surviving patients after one of these procedures, 1755 (16%) were lost to follow-up and 1172 (11%) lacked documentation of their smoking status at follow-up. The remaining 7807 patients (73%) were available for analysis. Patient factors independently associated with smoking cessation were determined using multivariate analysis. The relative contribution of patient and procedure factors including treatment center were measured by chi-pie analysis. Variation between treatment centers was further evaluated by calculating expected rates of cessation and by analysis of means. Vascular Study Group of New England surgeons were surveyed regarding their smoking cessation techniques (85% response rate).</p> <p>RESULTS: At the time of their procedure, 2606 of 7807 patients (33%) were self-reported current smokers. Of these, 1177 (45%) quit within the first year of surgery, with significant variation by procedure type (open abdominal aortic aneurysm repair, 50%; endovascular repair, 49%; lower extremity bypass, 46%; carotid endarterectomy, 43%; carotid artery stenting, 27%). In addition to higher smoking cessation rates with more invasive procedures, age >70 years (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.30-2.76; P < .001) and dialysis dependence (OR, 2.38; 95% CI, 1.04-5.43; P = .04) were independently associated with smoking cessation, whereas hypertension (OR, 1.23; 95% CI, 1.00-1.51; P = .051) demonstrated a trend toward significance. Treatment center was the greatest contributor to smoking cessation, and there was broad variation in smoking cessation rates, from 28% to 62%, between treatment centers. Cessation rates were higher than expected in three centers and significantly lower than expected in two centers. Among survey respondents, 78% offered pharmacologic therapy or referral to a smoking cessation specialist, or both. The smoking cessation rate for patients of these surgeons was 48% compared with 33% in those who did not offer medications or referral (P < .001).</p> <p>CONCLUSIONS: Patients frequently quit smoking after vascular surgery, and multiple patient-related and procedure-related factors contribute to cessation. However, we note significant influence of treatment center on cessation as well as broad variation in cessation rates between treatment centers. This variation indicates an opportunity for vascular surgeons to impact smoking cessation at the time of surgery. rights reserved.</p>
dc.identifier.submissionpathsurgery_pp/137
dc.contributor.departmentDepartment of Surgery
dc.source.pages1338-44; quiz 1344.e1-4


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