Smoking Is Not a Predictor of Mortality and Morbidity Following Coronary Artery Bypass Grafting

Utley, Joe R.; Leyland, Steven A.; Fogarty, Charles; Smith, Wilson P.; Knight, E. Bert; Feldman, Gregory; Wilde, Edwin F.

doi:10.1111/j.1540-8191.1996.tb00067.x

Cited by 17 publications

(15 citation statements)

References 32 publications

(1 reference statement)

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“…The current smoking levels were 22.9%. This level of smoking was more than double that noted in other studies [23] that have demonstrated an increased mortality in smokers compared to non-smokers at 5 years following surgery. Therefore, in the longer term, the study patients, who by comparison, reported higher levels of smoking, may be at increased risk of dying in the longer term following CABG.…”

Section: Discussionsupporting

confidence: 55%

Assessment of changes in general health status using the short-form 36 questionnaire 1 year following coronary artery bypass grafting

Lindsay¹

2000

European Journal of Cardio-Thoracic Surgery

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Objective: The problem addressed in the study was to gain a greater understanding of the health bene®ts of coronary artery bypass grafting (CABG). The purpose of the study was to assess general health status, using the short-form (SF)-36 questionnaire, approximately 12 months following CABG, and to document any associations between pre-operative health status, level of social support, coronary artery disease (CAD) risk factors, CAD symptom severity and post-operative health status. Methods: The study was prospective and observational in design and included assessments at two time points, namely pre-operatively in a hospital outpatient department (1995±1996) and postoperatively at home (1996±1997). Two hundred and fourteen patients awaiting elective CABG were recruited a month before the expected date of operation. Pre-operative assessment included: (1), severity of symptoms; (2), CAD risk factors; (3), SF-36 questionnaire; and (4), social activities questionnaire. Post-operative assessment measured health status using the SF-36 instrument (mean, 16.4 months). Correlation and multiple linear regression analyses were used to identify factors associated with improved health status following CABG. Results: Two hundred and fourteen patients were assessed pre-operatively and underwent CABG. There was a 4.8% 30-day mortality rate, and 183 patients were followed for a mean of 16.4 months after CABG. SF-36 scores following CABG were improved across all of the eight domains (P , 0:001). A higher social network score and higher pre-operative health status were associated with improved health status. Patients with lower health levels (SF-36 scores) prior to CABG were less likely to gain improvement in health (SF-36 scores) following CABG. Lower SF-36 scores following operation were in¯uenced by the presence of diabetes mellitus, cigarette smoking, younger age, a high socio-economic deprivation category and higher alcohol intake. Many patients had uncorrected CAD risk factors at pre-operative assessment. Conclusions: The SF-36 instrument was shown to be a useful and sensitive tool to assess differences and changes in the general health status of patients before and following CABG. High levels of social support were associated with improved health status post-operatively. Lower preoperative general health status, the presence of diabetes mellitus and cigarette smoking were associated with poorer post-operative general health status. q

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Section: Discussionsupporting

confidence: 55%

Assessment of changes in general health status using the short-form 36 questionnaire 1 year following coronary artery bypass grafting

Lindsay¹

2000

European Journal of Cardio-Thoracic Surgery

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“…Until recently, most available clinical studies were small, reported data from a single surgical specialty, or evaluated only a few postoperative outcomes. [2][3][4][5][6][7][8][9][10][11][12] However, 2 recent large multicenter studies 13,14 confirmed the association between smoking and adverse postoperative outcomes. Turan and colleagues 13 showed higher adjusted odds of postoperative mortality and major morbidity in 82 304 current smokers compared with those who never smoked (approximately 30% higher odds) using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP).…”

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confidence: 99%

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

et al. 2013

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Smoking cessation at least 1 year before major surgery abolishes the increased risk of postoperative mortality and decreases the risk of arterial and respiratory events evident in current smokers. These findings should be carried forward to evaluate the value and cost-effectiveness of intervention in this setting. Our study should increase awareness of the detrimental effects of smoking-and the benefits of its cessation-on morbidity and mortality in the surgical setting.

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“…7 Few limited studies have investigated the effect of active smoking on CABG operative outcomes and discordant results have been reported. [8][9][10][11][12] The main risk scoring systems in cardiac surgery such as EuroSCORE and STS score failed to investigate the effect of active smoking on operative mortality. 13 As a consequence, active smoking at the time of surgery is not commonly perceived as a main risk factor for operative morbidity and mortality, and smoking cessation programs are usually deferred until after surgery.…”

mentioning

confidence: 99%

Smoking cessation before coronary artery bypass grafting improves operative outcomes

Benedetto

Albanese

Kattach

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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Smoking Is Not a Predictor of Mortality and Morbidity Following Coronary Artery Bypass Grafting

Abstract: We conclude that there is no need to delay CABG for the patients who are smokers.

Cited by 17 publications

References 32 publications

Assessment of changes in general health status using the short-form 36 questionnaire 1 year following coronary artery bypass grafting

Assessment of changes in general health status using the short-form 36 questionnaire 1 year following coronary artery bypass grafting

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

Smoking cessation before coronary artery bypass grafting improves operative outcomes

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