Smoking is Associated with Poorer Quality-Based Outcomes in Patients Hospitalized with Spinal Disease

Bisson, Erica F.; Bowers, Christian A.; Hohmann, Samuel F.; Schmidt, Meic H.

doi:10.3389/fsurg.2015.00020

Cited by 21 publications

(10 citation statements)

References 44 publications

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“…The results of their study indicate that tobacco smoking is associated with an increased incidence of surgically treated LSS, especially among heavy smokers, who have a higher risk than moderate or former smokers [43]. The results are also consistent with previous reports indicating that cigarette smoking is associated with the occurrence of other spinal complaints, such as lumbar disc degeneration and LBP [44,45].…”

Section: Discussionsupporting

confidence: 87%

Occupational and non-occupational risk factors for neck and lower back pain among computer workers: a cross-sectional study

Malińska

Bugajska

Bartuzi

2021

International Journal of Occupational Safety and Ergonomics

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Objectives. The aim of this study was to identify major determinants for neck and lower back pain (LBP) among office workers of different ages. Methods. Computer workers (N = 2000) responded to a questionnaire on demographics, musculoskeletal disorders (MSDs), lifestyle characteristics, ergonomics of computer work and psychosocial and physical job characteristics. Results. Over 48% of respondents complained of MSDs last year, in particular neck pain and LBP. The results of logistic regression analysis revealed that prolonged computer time (odds ratio [OR] 1.92) and increased job demands (OR 1.06) were likely to increase the risk of neck pain, while social support (OR 0.96) and the use of seat-plate height adjustment (OR 0.64) would help to reduce the risk. Risk factors for LBP included smoking more than 14 cigarettes a day (OR 2.21), long hours spent working with a computer (OR 1.94), increased physical exertion at work (OR 1.29), increased work demands (OR 1.03) and older age (OR 1.03). Conclusions. The most effective way to eliminate MSD hazards in the workplace is to develop health programmes aimed at advocating healthy lifestyle behaviours and raising workers' awareness of workstation ergonomics and work organization, especially for women and older workers.

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Section: Discussionsupporting

confidence: 87%

Occupational and non-occupational risk factors for neck and lower back pain among computer workers: a cross-sectional study

Malińska

Bugajska

Bartuzi

2021

International Journal of Occupational Safety and Ergonomics

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“…In the published reports of the FDA clinical trials, 14,15,18 cigarette smoking was not specifically addressed for any enrolled patient. Although there is plenty of evidence indicating the adverse effects of smoking in spine surgery, including higher complication rates, 3,7,9 longer hospitalizations, 23 and lower fusion rates, 2,8,13,16 there has been a paucity of data on how cigarette consumption affects the outcomes of CDA. There have also been studies demonstrating higher rates of pseudarthrosis and infection in smoking patients after anterior cervical fusion.…”

mentioning

confidence: 99%

Effects of smoking on cervical disc arthroplasty

Kuo

Huang

et al. 2019

Journal of Neurosurgery: Spine

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OBJECTIVECigarette smoking can adversely affect bone fusion in patients who undergo anterior cervical discectomy and fusion. However, there is a paucity of data on smoking among patients who have undergone cervical disc arthroplasty (CDA). The present study aimed to compare the clinical and radiological outcomes of smokers to those of nonsmokers following CDA.METHODSThe authors retrospectively reviewed the records of consecutive patients who had undergone 1- or 2-level CDA for cervical disc herniation or spondylosis and had a minimum 2-year follow-up. All patients were grouped into a smoking group, which consisted of those who had consumed cigarettes within 6 months prior to the CDA surgery, or a nonsmoking group, which consisted of those who had not consumed cigarettes at all or within 6 months of the CDA. Clinical outcomes were evaluated according to the visual analog scale for neck and arm pain, Neck Disability Index, Japanese Orthopaedic Association Scale, and Nurick Scale at each time point of evaluation. Radiological outcomes were assessed using radiographs and CT for multiple parameters, including segmental range of motion (ROM), neutral lordotic curve, and presence of heterotopic ossification (HO).RESULTSA total of 109 patients completed at least 2 years of follow-up and were analyzed (mean follow-up 42.3 months). There were 89 patients in the nonsmoking group and 20 in the smoking group. The latter group was younger and predominantly male (both p < 0.05) compared to the nonsmoking group. The two groups had similar improvements in all clinical outcomes after CDA compared to preoperatively. Radiological evaluations were also very similar between the two groups, except for two factors. The smoking group had well-preserved segmental ROM after CDA at an average of 8.1° (both pre- and postoperation). However, while the nonsmoking group remained mobile, segmental ROM decreased significantly (8.2° to 6.9°, p < 0.05) after CDA. There was a trend toward more HO development in the nonsmoking group than in the smoking group, but the difference was without significance (59.6% vs 50.0%, p = 0.43).CONCLUSIONSDuring an average 3.5 years of follow-up after 1- and 2-level CDA, cigarette smokers and nonsmokers had similar improvements in clinical outcomes. Moreover, segmental mobility was slightly better preserved in smokers. Since smoking status did not negatively impact outcomes, CDA may be a reasonable option for selected patients who have smoked.

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“…In our study, preoperative factors associated with longer LoS on multivariable analysis included tobacco use and the presence of polytrauma. Tobacco use is associated with a wide array of surgical morbidities and mortality [ 14 - 16 ], including increased rates of intubation, infection, and myocardial infarction [ 17 ]. All of these complications frequently result in the need for extended hospitalization, and therefore, this relationship is unsurprising.…”

Section: Discussionmentioning

confidence: 99%

Multivariable Analysis of Factors Affecting Length of Stay and Hospital Charges After Atlantoaxial Fusion

Guan

Karsy

Schmidt

et al. 2017

Cureus

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BackgroundAtlantoaxial fusion is an effective procedure for treating degenerative, traumatic, and congenital abnormalities that result in upper cervical instability; however, data on which factors affect the length of stay and hospitalization-related charges are limited. The purpose of this study was to evaluate the pre-, intra-, and postoperative variables that affect these healthcare cost factors for patients undergoing posterior atlantoaxial fusion.MethodsWe retrospectively identified from a clinical database 59 patients who underwent isolated posterior atlantoaxial fusion at a single institution from 2010 to 2015. Demographic, clinical, and surgical variables from a clinical database were analyzed with respect to the length of hospital stay and hospital charges. T-test and Chi-square testing, as well as univariate and multivariable analysis, were performed with p<0.05 considered significant.ResultsOn multivariable analysis, a variety of preoperative, intraoperative, and postoperative variables were associated with prolonged hospitalization and higher hospital charges, including tobacco use, preoperative diagnosis, operating room time, and the need for intraoperative blood transfusion.ConclusionsVaried preoperative, intraoperative, and postoperative factors are associated with increased length of hospitalization and higher hospital charges after atlantoaxial fusion. Familiarity with these factors may allow for improved surgical planning and patient counseling.

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Smoking is Associated with Poorer Quality-Based Outcomes in Patients Hospitalized with Spinal Disease

Cited by 21 publications

References 44 publications

Occupational and non-occupational risk factors for neck and lower back pain among computer workers: a cross-sectional study

Occupational and non-occupational risk factors for neck and lower back pain among computer workers: a cross-sectional study

Effects of smoking on cervical disc arthroplasty

Multivariable Analysis of Factors Affecting Length of Stay and Hospital Charges After Atlantoaxial Fusion

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