Smoking Cessation Associated With Reduced Postoperative Complications After Major Surgery

Date: Jun-19-2013JAMA Surgery Study Highlights

Smoking cessation at least one year before major surgery eliminates the increased risk of postoperative mortality and decreases the risk of arterial and respiratory events evident in current smokers, according to a study by Khaled M. Musallam, M.D., Ph.D., of the American University of Beirut Medical Center, Lebanon and colleagues. (Online First)

A total of 125,192 current and 78,763 past smokers from the American College of Surgeons National Surgical Quality Improvement Program database who underwent a major surgery were included in the study sample. The study authors measured for 30-day postoperative death, arterial (major) events, venous events, and respiratory events.

Increased odds of postoperative mortality were noted in current smokers. When the authors compared current and past smokers, adjusted odds ratios were higher in the current smokers for arterial events and respiratory events, but there were no difference for venous events. The increased adjusted odds of mortality in current smokers were evident from a smoking history of less than 10 pack-years, whereas the relationship between smoking and arterial and respiratory events was incremental with increased pack-years.

"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," the authors conclude.

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