Smoking and the Risk of Mortality and Vascular and Respiratory Events in Patients Undergoing Major Surgery

Musallam, Khaled M.; Rosendaal, Frits R.; Zaatari, Ghazi; Soweid, Assaad; Hoballah, Jamal J.; Sfeir, Pierre; Zeineldine, Salah; Tamim, Hani; Richards, Toby; Spahn, Donat R.; Lotta, Luca A.; Peyvandi, Flora; Jamali, Faek R.

doi:10.1001/jamasurg.2013.2360

Cited by 144 publications

(99 citation statements)

References 41 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 By stratifying patients into 3 groups, our study could more directly compare the role of perioperative smoking in influencing angiographically determined outcomes of aneurysm treatment.…”

Section: Discussionmentioning

confidence: 99%

Smoking is not associated with recurrence and retreatment of intracranial aneurysms after endovascular coiling

Brinjikji¹,

Lingineni²,

Gu³

et al. 2015

JNS

View full text Add to dashboard Cite

T obacco smoking is one of the most important risk factors for intracranial aneurysm formation and for an aneurysmal subarachnoid hemorrhage (aSAH). 2,[6][7][8][9]12,13 Previous studies have shown that smoking cigarettes increases the risk for an aSAH up to 6-fold when compared with the risk in the general population. 2,12Results from one study have indicated that smoking also represents a risk factor for the recurrence of an aneurysm after its treatment with endovascular coiling.11 To gain a better understanding of the impact of smoking on long- OBJect Tobacco smoking is one of the most important risk factors for the formation of intracranial aneurysms and for aneurysmal subarachnoid hemorrhages. Smoking has also been suggested to contribute to the recurrence of aneurysms after endovascular coiling. To improve the understanding of the impact of smoking on long-term outcomes after coil embolization of intracranial aneurysms, the authors studied a consecutive contemporary series of patients treated at their institution. The aims of this study were to determine whether smoking is an independent risk factor for aneurysm recurrence and retreatment after endovascular coiling. MetHODs All patients who had received an intrasaccular coil embolization of an intracranial aneurysm, who had undergone a follow-up imaging exam at least 6 months later, and whose smoking history had been recorded from January 2005 through December 2012 were included in this study. Patients were stratified according to smoking status into 3 groups: 1) never a smoker, 2) current smoker (smoked at the time of treatment), and 3) former smoker (quit smoking before treatment). The 2 primary outcomes studied were aneurysm recurrence and aneurysm retreatment after treatment for endovascular aneurysms. Kruskal-Wallis and chi-square tests were used to test statistical significance of differences in the rates of aneurysm recurrence, retreatment, or of both among the 3 groups. A multivariate logistic regression analysis controlling for smoking status and for several characteristics of the aneurysm was also performed. resUlts In total, 384 patients with a combined total of 411 aneurysms were included in this study. The aneurysm recurrence rate was not significantly associated with smoking: both former smokers (OR 1.00, 95% CI 0.61-1.65; p = 0.99) and current smokers (OR 0.58, 95% CI 0.31-1.09; p = 0.09) had odds of recurrence that were similar to those who were never smokers. Former smokers (OR 0.78, 95% CI 0.46-1.35; p = 0.38) had odds of retreatment similar to those of never smokers, and current smokers had a lower odds of undergoing retreatment (OR 0.44, 95% CI 0.21-0.91; p = 0.03) than never smokers. Moreover, an analysis adjusting for aneurysm rupture, diameter, and initial occlusion showed that former smokers (OR 0.65, p = 0.21) and current smokers (OR 1.04, 95% CI 0.60-1.81; p = 0.88) had odds of aneurysm recurrence similar to those who were never smokers. Adjusting the analysis for aneurysm rupture, diameter, and occlusion showed that both former s...

show abstract

Section: Discussionmentioning

confidence: 99%

Smoking is not associated with recurrence and retreatment of intracranial aneurysms after endovascular coiling

Brinjikji¹,

Lingineni²,

Gu³

et al. 2015

JNS

View full text Add to dashboard Cite

show abstract

“…4 In consequence, smoking has been shown to be an independent risk factor of poor early perioperative outcomes following a variety of surgical procedures. [5][6][7][8] The impact of smoking on surgical outcomes is related to transient perturbations of the tissue microenvironment and the prolonged effect on inflammatory and reparative cell functions. 9 Specifically, higher rates of respiratory and cardiovascular events as well as surgical site infections have been reported among current smokers.…”

mentioning

confidence: 99%

“…9 Specifically, higher rates of respiratory and cardiovascular events as well as surgical site infections have been reported among current smokers. [5][6][7] On the basis of these previous investigations, we sought to determine the effect of current and prior smoking on the incidence of early perioperative (30-day period) adverse events within a comprehensive group of 16 major surgeries (cardiovascular, orthopedic, or oncologic surgical procedures). We used data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), a multi-institutional prospective data collection initiative to facilitate the assessment of surgical outcomes and complications.…”

mentioning

confidence: 99%

Impact of smoking on perioperative outcomes after major surgery

Schmid

Sood

Campbell

et al. 2015

The American Journal of Surgery

View full text Add to dashboard Cite

“…Alcohol and smoking should be reduced and ceased preoperatively (7,8) to reduce the risk of infections, respiratory, and neurological complications and the intensive care unit (ICU) stay (9). Whether preoperative spirometry training is beneficial in patients undergoing thoracotomy and lung resection (10) and despite lacking data it should be recommended in patients for LVR.…”

Section: Preoperative Managementmentioning

confidence: 99%