Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial

Møller, Ann Merete; Villebro, Nete; Pedersen, T.; Tønnesen, Hanne

doi:10.1016/s0140-6736(02)07369-5

Cited by 951 publications

(657 citation statements)

References 23 publications

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“…Current smoker has an additional risk, and there is a correlation between the cumulative amount of smoking and the risk of PPCs [33]. A randomized, controlled trial has demonstrated that patients ceased smoking for 6–8 weeks before elective major orthopedic surgery had a reduced risk of PPCs [34]. However, the role of smoking cessation before hip fracture surgery remains controversial.…”

Section: Risk Factors For Ppcsmentioning

confidence: 99%

Pre-operative pulmonary assessment for patients with hip fracture

Siu

Tse

et al. 2010

Osteoporos Int

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Hip fracture is a common injury among the elderly. Although patients who receive hip fracture surgery carry the best functional recovery compared to other treatment modalities, the presence of postoperative pulmonary complications, such as atelectasis, pneumonia, and pulmonary thromboembolism, may contribute to increased length of hospital stay, perioperative morbidity, and mortality. This review aims to provide evidence-based recommendations for preoperative assessment and perioperative strategies to reduce the risk of pulmonary complications after hip fracture surgery. Clinical assessment and basic laboratory results are sufficient to stratify the risk of postoperative pulmonary complications. Well-documented risk factors for pulmonary complications include advanced age, poor general health status, current infections, pre-existing cardiopulmonary diseases, hypoalbuminemia, and impaired renal function. Apart from optimizing the patient's medical conditions, interventions such as lung expansion maneuvers and thromboprophylaxis have been proven to be effective in reducing the risk of pulmonary complications after hip fracture surgery.

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Section: Risk Factors For Ppcsmentioning

confidence: 99%

Pre-operative pulmonary assessment for patients with hip fracture

Siu

Tse

et al. 2010

Osteoporos Int

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“…Continued tobacco use after a cancer diagnosis has been associated with various detrimental clinical outcomes such as shorter survival (Videtic et al, 2003;Fox et al, 2004;Sardari Nia et al, 2005;Zhou et al, 2006;Nguyenet al, 2010;Parsonset al, 2010;Kenfield, et al, 2011); increased risk of tumor recurrence or development of secondary malignancies (Do et al, 2003;Kawaguchi et al, 2006;Garces et al, 2007;Kaufman et al, 2008;Li et al, 2009;Joshu et al, 2011); poorer response to treatment and an increased risk of treatment toxicities (Monson et al, 1998;Dresler, 2003;O'Sullivan et al, 2003;van der Bol et al, 2007;de Jong et al, 2008;Waller et al, 2011;Petros et al, 2012); an increased risk of surgical complications (Moller et al, 2002;Barrera et al, 2005;Selber et al, 2006;Liu et al, 2011); and inferior bone marrow transplantation outcomes (Marks et al, 2009;Ehlers et al, 2011 ;Tran et al, 2011). Conversely, smoking cessation post-cancer diagnosis has been associated with better pain control and an improved quality of life (Garces et al, 2004;Baser et al, 2006;Daniel et al, 2009;Ditre et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Smoking Cessation Treatment and Outcomes in Medium to Heavy Cigarette Smokers being Treated for Cancer in Jordan

Hawari¹,

Obeidat²,

Ayub³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan. Materials and Methods: Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6-and 12-month) followup by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed. Results: A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (≤10ppm) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Longterm ARs did not reach 7%. Conclusions: In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.

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“…8]. Preoperative smoking cessation interventions, when patients quit at least 6 weeks prior to surgery, have been shown to be effective at increasing the likelihood that smokers will quit as well as reducing postoperative outcomes [8][9][10][11][12][13]. Implementation of smoking cessation interventions in the preoperative period is challenging.…”

Section: Introductionmentioning

confidence: 99%

Translating preoperative smoking cessation interventions into routine clinical care of veterans: provider beliefs

Vick

Graham

Henderson³

et al. 2011

Behav. Med. Pract. Policy Res.

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Smoking among veterans undergoing surgery is estimated to be 36%. Smoking has been linked to postoperative surgical complications including ischemia and cardiac arrhythmias, pneumonia, deep venous thrombosis, pulmonary embolism, and surgical site infection. Preoperative smoking cessation interventions, in which smokers quit at least 6weeks prior to surgery, have been shown to be effective both in smoking cessation and reduction of postoperative complications; however, little is known about physician beliefs regarding the optimal location and the responsible provider for intervention, or whether surgery should be postponed or delayed based on smoking status. Within the routine coordination from medical to surgical care, how should cessation interventions best be implemented? To better inform the translation of preoperative best practices for smoking cessation into clinical care in VA, a survey regarding preoperative smoking cessation beliefs and practices was administered to primary care physicians, surgeons, and anesthesia providers. Chi-square tests were used to examine differences in proportions by provider type. Most providers agreed that the primary care clinic is the best location for intervention, with preoperative and surgical clinics ranked by few as the optimal location (13% and 11%, respectively); most respondents (82%) reported that they would refuse or delay surgery in some cases based on smoking status. There were no differences in either beliefs on location or delay based on provider type. Primary care providers were most likely to advise (86.7%) and assess (80.0%) while anesthesia providers were least likely (59.1% and 22.7%, respectively). Taking time to counsel and the belief that dedicated resources would improve quit rates were associated with advising patients to quit smoking, while being uncomfortable with counseling, the belief that acute health takes precedence and the belief that there is not always time to counsel were identified as barriers to assessing patients for smoking cessation intervention. Primary care providers were more optimistic (100%) that patients would quit if counseled, more often (73.3%) reported having time to counsel, and were less likely to report that acute health takes precedence. Most providers believe that smoking cessation would reduce postoperative complications, with the ideal location for the intervention being the primary care clinic, and that some surgical cases should be delayed for this intervention.

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Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial

Cited by 951 publications

References 23 publications

Pre-operative pulmonary assessment for patients with hip fracture

Pre-operative pulmonary assessment for patients with hip fracture

Smoking Cessation Treatment and Outcomes in Medium to Heavy Cigarette Smokers being Treated for Cancer in Jordan

Translating preoperative smoking cessation interventions into routine clinical care of veterans: provider beliefs

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