A Prospective Study of Tobacco Smoking as a Predictor of Complications in General Surgery

Abstract

Smoking increases in-hospital mortality, admission to the intensive care unit, and lower respiratory tract infection, but not surgical-site infection. Deleterious effects of smoking are also observed in past smokers and they cannot be counteracted by hospital cessation programs.

Systemic Inflammatory Response Syndrome Score and Race As Predictors of Length of Stay in the Intensive Care Unit

“…Consistent with the findings of the present research, Jurkovich and colleagues 28 reported that smoking did not increase the odds for prolonged ICU length of stay in patients with acute injuries. Similarly, Delgado-Rodriguez et al 29 reported that smoking was not a significant predictor for ICU length of stay in general surgery patients, although smokers in their study did have longer adjusted ICU lengths of stay (11.3 days vs 6.4 days). In contrast, when Baldwin and colleagues 30 examined both medical and surgical ICU patients, smoking was a significant predictor for ICU length of stay (P = .008), as it was in a study of patients who underwent coronary bypass surgery (P < .05).…”

“…In contrast, when Baldwin and colleagues 30 examined both medical and surgical ICU patients, smoking was a significant predictor for ICU length of stay (P = .008), as it was in a study of patients who underwent coronary bypass surgery (P < .05). 31 All 4 of these studies [28][29][30][31] were prospective analyses in which smoking status was obtained from chart documentation based on patient interviews.…”

Identification of risk factors by systematic review and development of risk-adjusted models for surgical site infection

“…The 16 papers included described patient populations for selected specialties, one or more hospitals, or from national surveillance programmes (Table 8) over a period of > 20 years. 32,[66][67][68][69][70][71][72][73][74][75][76][77][78][79][80] We describe the findings of these studies in a purely qualitative manner because of the varied way in which they were reported in the primary studies and heterogeneity between the studies.…”

“…66 A range of other additional risk factors was identified in fewer studies. Smoking was commented on by researchers in three papers, but in two this was expressly to state that smoking was not associated with SSI; 68,74 these studies had larger sample sizes than the one study that reported smoking to be associated with an increased risk of SSI. 79 Other risk factors reported in more than one study were heavy alcohol consumption, diabetes and multiple interventions.…”

II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia

“…The history of smoking is associated with longer stays in intensive care units (ICU) postoperatively and longer hospitalizations [364][365][366] , in spite of this, little is approached along the smoking preoperative patient , which is partly due to unfamiliarity with the doctors or the optimum timing of smoking abstinence. Recognizing the best moment to address the issue of smoking and start treatment as early as possible can translate into meaningful reductions in clinical and surgical complications and reduce costs to the health system.…”