title: Tobacco use and surgical outcomes in patients with head and neck cancer.
abstract: BACKGROUND
  Tobacco use is a risk factor for head and neck cancer, but effects on postoperative outcomes are unclear.
  
  
  METHODS
  Patients with head and neck cancer (n = 89) were recruited before surgery. We assessed self-reported tobacco use status (never, former, or current) at study entry and recent tobacco exposure via urinary cotinine on surgery day. Outcomes included hospital length of stay (LOS) and complications.
  
  
  RESULTS
  Most participants reported current (32.6%) or former (52.8%) tobacco use; 43.2% were cotinine-positive on surgery day. Complications occurred in 41.6% and mean LOS was 4.0 and 8.8 days in patients who received low and high acuity procedures, respectively. Current and former smokers were over 6 times more likely to have complications than never smokers (p = .03). For high acuity procedures, LOS was increased in current (by 4.4 days) and former smokers (by 2.3 days; p = .02).
  
  
  CONCLUSIONS
  Tobacco use status is associated with postoperative complications and may distinguish at-risk patients.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Jeanne L
authors.initials: JL
authors.lastname: Hatcher
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Sterba
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Tooze
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Terry A
authors.initials: TA
authors.lastname: Day
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carpenter
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Alberg
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Sullivan
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Nora C
authors.initials: NC
authors.lastname: Fitzgerald
authors.affiliation: Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Weaver
mesh_terms: D000368:Aged; D003367:Cotinine / Q000652:urine; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery* / Q000652:urine; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D064424:Tobacco Use / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D003367:Cotinine
keywords: cotinine; head and neck cancer; length of stay; postoperative complication; tobacco