Effect of Smoking Status on Mortality and Morbidity Following Coronary Artery Bypass Surgery

Abstract

Rupture of the left ventricular free wall is one of the most serious complications of myocardial infarction. A 73-year-old man with severe chest pain visited our hospital. Coronary angiography revealed acute myocardial infarction in the territory of the diagonal branch. About six hours after successful percutaneous coronary intervention, the patient fell into cardiogenic shock with chest pain. Echocardiography showed moderate pericardial effusion with a subepicardial hematoma, and percardioentesis led to the diagnosis of free wall rupture. Emergency surgery was performed with the use of intra-aortic balloon pumping. The rupture was a blowout type in a small tear at the anterolateral wall of the left ventricle. We repaired the tear with an off-pump sutureless patch using collagen fleece with fibrinogen-based impregnation (TachoComb) and equinous pericardium with fibrin spray. The patient was free of both re-rupture and pseudoaneurysm postoperatively, and was discharged 20 days after the operation. Considering previously reported various procedures for surgical repair, this technique may be useful if the tear is small.

Risky Alcohol Use: The Impact on Health Service Use

“…On the other hand, the sensitivity analyses found a robust relationship between cigarette smoking and an increased health service use. Consistent findings have been previously reported describing former and current cigarette smokers using more the health services compared to those who have never smoked [24]. Smoking status has been strongly associated with an increased number of hospitalizations, longer hospital stays [12,32] and a higher number of emergency, in-and outpatient visits [9] among cigarette smokers; as well as being even higher among former-smokers [9].…”

“…In addition, tobacco smoking is highly prevalent among alcohol consumers, especially in risky drinkers [21] and alcohol-dependent patients [22]. Cigarette smoking increases morbidity when co-occurring with alcohol use disorder [23] and, consequently, increases health service use [9,24]. We undertook a sensitivity analysis stratifying the sample by socioeconomic status and tobacco consumption to examine the associations between these aspects and service use in our sample.…”

The Risk-Adjusted Impact of Intraoperative Hemofiltration on Real-World Outcomes of Patients Undergoing Cardiac Surgery

“…All data were collected (Table 1) during in-patient admission as part of the routine clinical practice as previously described [17]. In-hospital mortality was de ined as deaths within the same hospital admission regardless of cause or within 30 days of hospital discharge.…”

Mediation of smoking-associated postoperative mortality by perioperative complications in veterans undergoing elective surgery: data from Veterans Affairs Surgical Quality Improvement Program (VASQIP)—a cohort study

“…11 While smoking-related postoperative morbidity is important, smoking is also associated with increased postoperative mortality. [12][13][14] There are several proposed mechanisms of increased mortality in the perioperative period for smokers including higher risk of cardiac 13 14 and pulmonary complications. 12 To our knowledge, no previous studies have assessed to what degree the increased smoking-associated postoperative mortality is mediated by specific complications associated with smoking.…”