Preoperative smoking habits and postoperative pulmonary complications.
OBJECTIVE
To examine the effect of preoperative smoking behavior on postoperative pulmonary complications.


METHODS
Prospective cohort study.


METHODS
The Veterans Administration Medical Center, Syracuse, NY.


METHODS
Patients scheduled for noncardiac elective surgery (n=410).


RESULTS
Smoking status was determined by self-report. Postoperative pulmonary complications were determined by systematic extraction of medical record data. Postoperative pulmonary complications occurred in 31 of 141 (22.0%) current smokers, 24 of 187 (12.8%) past smokers, and 4 of 82 (4.9%) never smokers. The odds ratio (OR) for developing a postoperative pulmonary complication for current smokers vs never smokers was 5.5 (95% confidence interval [CI], 1.9 to 16.2) and 4.2 (95% CI, 1.2 to 14.8) after adjustment for type of surgery, type of anesthesia, abnormal chest radiograph, chronic cough, history of pulmonary disease, history of cardiac disease, history of COPD, education level, pulmonary function, body mass index, and age. Current smokers who reported reducing cigarette consumption prior to surgery were more likely to develop a complication compared with those who did not (adjusted OR=6.7, 95% CI, 2.6 to 17.1).


CONCLUSIONS
Current smoking was associated with a nearly sixfold increase in risk for a postoperative pulmonary complication. Reduction in smoking within 1 month of surgery was not associated with a decreased risk of postoperative pulmonary complications.
Bluman
L G
LG
Cancer Prevention, Detection and Control Research Program, Comprehensive Cancer Center, Duke University Medical Center, Durham, NC, USA.
Mosca
L
L
Newman
N
N
Simon
D G
DG
D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D013514:Surgical Procedures, Operative