A Prospective Study of Tobacco Smoking as a Predictor of Complications in General Surgery
- 2 January 2003
- journal article
- Published by Cambridge University Press (CUP) in Infection Control & Hospital Epidemiology
- Vol. 24 (1), 37-43
- https://doi.org/10.1086/502113
Abstract
Objective: To analyze whether tobacco smoking is related to nosocomial infection, admission to the intensive care unit, in-hospital death, and length of stay.Design: A prospective cohort study.Setting: The Service of General Surgery of a tertiary-care hospital.Patients: A consecutive series of patients admitted for more than 1 day (N = 2,989).Results: Sixty-two (2.1%) patients died and 503 (16.8%) acquired a nosocomial infection, of which 378 (12.6%) were surgical site and 44 (1.5%) were lower respiratory tract. Smoking (mainly past smoking) was associated with a worse health status (eg, longer preoperative stay and higher American Society of Anesthesiologists score). A long history of smoking (≥ 51 pack-years) increased post-operative admission to the intensive care unit (adjusted odds ratio [OR] = 2.86; 95% confidence interval [CI95], 1.21 to 6.77) and in-hospital mortality (adjusted OR = 2.56; CI95, 1.10 to 5.97). There was no relationship between current smoking and surgical-site infection (adjusted OR = 0.99; CI95, 0.72 to 1.35), whereas a relationship was observed between past smoking and surgical-site infection (adjusted OR = 1.46; CI95, 1.02 to 2.09). Current smoking and, to a lesser degree, past smoking augmented the risk of lower respiratory tract infection (adjusted OR = 3.21; CI95, 1.21 to 8.51). Smokers did not undergo additional surgical procedures more frequently during hospitalization. In the multivariate analysis, length of stay was similar for smokers and nonsmokers.Conclusion: Smoking increases in-hospital mortality, admission to the intensive care unit, and lower respiratory tract infection, but not surgical-site infection. Deleterious effects of smoking are also observed in past smokers and they cannot be counteracted by hospital cessation programs.Keywords
This publication has 52 references indexed in Scilit:
- Factors Contributing to a Prolonged Stay After Ambulatory SurgeryAnesthesia & Analgesia, 1999
- Factors Contributing to a Prolonged Stay After Ambulatory SurgeryAnesthesia & Analgesia, 1999
- Smoking and Joint ReplacementPublished by Ovid Technologies (Wolters Kluwer Health) ,1999
- Less collagen production in smokersSurgery, 1998
- Acute Stroke Care and Rehabilitation: An Analysis of the Direct Cost and Its Clinical and Social DeterminantsStroke, 1997
- Clinical epidemiology of acute myocardial infarction in Sharjah, United Arab EmiratesInternational Journal of Cardiology, 1997
- Impact of preoperative risk and perioperative morbidity on ICU stay following coronary bypass surgeryCardiovascular Surgery, 1996
- Prediction of Rib Fracture Injury Outcome by an Artificial Neural NetworkJournal Of Trauma-Injury Infection and Critical Care, 1995
- The Effect of Smoking on Muscle TranspositionPlastic and Reconstructive Surgery, 1994
- Comparison of death rates from acute myocardial infarction in a single hospital in two different periods (1977–1978 versus 1988–1989)The American Journal of Cardiology, 1993