Preoperative Smoking Status and Postoperative Complications

Grønkjær, Marie; Eliasen, Marie; Skov-Ettrup, Lise; Tolstrup, Janne S; Christiansen, Anne Hjøllund; Mikkelsen, Stine Schou; Becker, Ulrik; Flensborg‐Madsen, Trine

doi:10.1097/sla.0b013e3182911913

Cited by 301 publications

(227 citation statements)

References 128 publications

(68 reference statements)

Supporting

Mentioning

202

Contrasting

Unclassified

Order By: Relevance

“…This suggests that the relationship may be explained, at least in part, by effects of smoking on surgical outcomes. A recent major meta-analysis found that, in the 30 days after surgery, preoperative smoking increased risk of wound complications, general infections, pulmonary infections, neurologic complications, and admission to an intensive care unit (33). In patients with head and neck cancer specifically, in a recent review, Lassig and colleagues (6) reported that smoking was associated with systemic perioperative complications (such as pneumonia) in 6 of 14 studies of extirpative surgery without microvascular reconstruction and with complications in general in 11 of 22 studies of reconstruction.…”

Section: Smoking and Treatmentmentioning

confidence: 99%

Smoking at Diagnosis Is an Independent Prognostic Factor for Cancer-Specific Survival in Head and Neck Cancer: Findings from a Large, Population-Based Study

Sharp

McDevitt

Carsin

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

Background: Some studies suggest smoking may result in poorer clinical outcomes in head and neck cancer, but the evidence is heterogeneous and some of it is poor quality. In a large, population-based, study we investigated: (i) whether smoking at diagnosis is an independent prognostic factor for cancer-specific survival in head and neck cancer; and (ii) whether the association varies by site and treatment.Methods: Head and neck cancers (ICD10 C01-C14, and C30-32) diagnosed from 1994 to 2009 were abstracted from the National Cancer Registry Ireland, and classified by smoking status at diagnosis. Follow-up was for 5 years or until December 31, 2010. Multivariate Cox proportional hazards models were used to compare cancerspecific death rates in current, ex-, and never smokers. Subgroup analyses by site and treatment were conducted.Results: In total, 5,652 head and neck cancers were included. At diagnosis, 24% were never smokers, 20% exsmokers, and 56% current smokers. Compared with never smokers, current smokers had a significantly raised death rate from cancer [multivariate HR, 1.36; 95% confidence interval (CI), 1.21-1.53]. The association was similar after restriction to squamous cell tumors. A significantly increased cancer-related death rate was seen for current smokers with oral cavity, pharyngeal, and laryngeal cancers. The association was stronger in surgically treated patients [HR, 1.49; 95% CI, 1.25-1.79; P(interaction) ¼ 0.01]. Neither radiotherapy nor chemotherapy modified the effect of smoking.Conclusions: Patients with head and neck cancer who smoke at diagnosis have a significantly increased cancer death rate.Impact: Greater efforts are needed to encourage and support smoking cessation in those at risk of, and diagnosed with, head and neck cancer. Cancer Epidemiol Biomarkers Prev; 23(11); 2579-90. Ó2014 AACR.

show abstract

Section: Smoking and Treatmentmentioning

confidence: 99%

Smoking at Diagnosis Is an Independent Prognostic Factor for Cancer-Specific Survival in Head and Neck Cancer: Findings from a Large, Population-Based Study

Sharp

McDevitt

Carsin

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

show abstract

“…[40][41][42] Sepsis, systemic inflammatory response syndrome, smoking, and corticosteroid use were predictive of postoperative complications, congruent with the existing literature. [43][44][45][46] Smoking cessation at least 4 weeks before elective procedures will reduce postoperative pulmonary and wound complications. 45 Preoperative acute delirium and septic shock were predictive of mortality.…”

Section: Original Research and Contributionsmentioning

confidence: 99%

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Irojah¹,

Bell

Grim

et al. 2017

TPJ

View full text Add to dashboard Cite

Context: Cholecystectomy is the most common general surgery procedure in patients older than age 65 years. By 2050, it is estimated that 2.0% of the population will be older than age 90 years.Objective: To assess the mortality of cholecystectomy in superelderly patients (≥ age 90 years).Design were open and 791 (78.6%) were laparoscopic. Mortality did not decrease significantly during the study period. The overall mortality was 5.5%, significantly less for the laparoscopic group (3.7% vs 12%, p < 0.001) and for the nonemergent group (4.5% vs 9.5%, p < 0.005). The median length of stay for open cholecystectomy was 9 days compared with 5 days for laparoscopic (p < 0.001); for nonemergent cholecystectomy it was 5 days compared with 7 days for emergent cholecystectomy (p < 0.001).Conclusion: The mortality after cholecystectomy in superelderly patients did not change significantly during the study period. The mortality and morbidity for laparoscopic and elective procedures were significantly lower than for open procedures and for emergent procedures, respectively.

show abstract

“…Contrasting our data, a meta-analysis of all postsurgical outcomes in non-CF current smokers did not show an increase in acute rejection. 23 However, CF patients represent a unique group of patients with differing immune responses, therefore making our findings relevant. Chronic rejection could not be assessed in this study based on the recent changes in nomenclature and previous coding in UNOS.…”

Section: Discussionmentioning

confidence: 96%

Untitled

2015

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: The effect of prior cigarette use by lung transplant donors and recipients on posttransplant survival is poorly defined, especially in subjects with cystic fibrosis. We sought to determine if donor or recipient cigarette smoking is associated with differential postlung transplant outcomes in cystic fibrosis patients, including survival. Materials and Methods: The United Network for Organ Sharing database was searched to analyze a large sample of cystic fibrosis patients with a history of lung transplant. The primary endpoint of the study was overall survival after transplant based on either recipient or donor history of smoking cigarettes. Results: There was a significant decrease in survival for cystic fibrosis patients who received lungs from a donor with a history of smoking (P = .026), but no difference in survival for recipients with a personal history of smoking. Nearly 60% of subjects who received lungs from a smoking donor died during the study. Donor smoking history was correlated with survival in a univariate (HR 1.2, [1.04-1.3]), but not multivariate model. Donor smoking history also was associated with increased treatment for rejection within the first year after transplant (P = .005). Conclusions:More than 20 pack-year history of donor smoking may affect lung transplant outcomes (eg, survival and acute rejection) in patients with cystic fibrosis. Caution must be exercised when choosing suitable organ donors for cystic fibrosis patients requiring a lung transplant.

show abstract

Preoperative Smoking Status and Postoperative Complications

Abstract: Preoperative smoking was found to be associated with an increased risk of the following postoperative complications: general morbidity, wound complications, general infections, pulmonary complications, neurological complications, and admission to the intensive care unit.

Cited by 301 publications

References 128 publications

Smoking at Diagnosis Is an Independent Prognostic Factor for Cancer-Specific Survival in Head and Neck Cancer: Findings from a Large, Population-Based Study

Smoking at Diagnosis Is an Independent Prognostic Factor for Cancer-Specific Survival in Head and Neck Cancer: Findings from a Large, Population-Based Study

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Untitled

Contact Info

Product

Resources

About