Effect of smoking status on mortality and morbidity following coronary artery bypass surgery.
BACKGROUND
We aimed to examine the effect of smoking on outcomes following coronary artery bypass grafting (CABG).


METHODS
We retrospectively analysed 6 367 consecutive patients who underwent CABG between April 1997 and March 2003. Logistic regression was used to risk adjust in-hospital outcomes, while Cox proportional hazards analysis was used to risk adjust Kaplan-Meier survival curves. Outcomes were adjusted for variables suggested by the American Heart Association and American College of Cardiology.


RESULTS
947 (14.9 %) patients were current smokers (smoking within 1 month of surgery), while 3857 (60.6 %) were ex-smokers and 1 563 (24.5 %) were non-smokers. After adjusting for differences in case-mix, current smokers were more likely to develop chest infections ( p < 0.001), atelectasis ( p < 0.001), and require ventilation longer than 48 hours ( p = 0.003). Current smokers were also more likely to stay in intensive care for more than 3 days ( p < 0.001). Ex-smokers were not associated with excess mortality ( p = 0.11), while current smokers had significantly increased mortality during follow-up ( p = 0.029).


CONCLUSIONS
Patients should be encouraged to stop smoking to maximise the long-term benefits of CABG.
Ashraf
M N
MN
Department of Cardiothoracic Surgery, Cardiothoracic Centre, Liverpool, United Kingdom.
Mortasawi
A
A
Grayson
A D
AD
Oo
A Y
AY
D000368:Aged; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D001261:Pulmonary Atelectasis / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis