The Effect of Smoking on 30-Day Complications Following Radical Prostatectomy.
The purpose of this study was to determine if smoking status is associated with 30-day postoperative complications following radical prostatectomy.



From the American College of Surgeons National Surgical Quality Improvement Program's (NSQIP) 2005-2013 database, we identified patients who underwent prostatectomy for treatment of prostate cancer. The cohort was stratified into current smokers, former smokers, and never smokers. Bivariable and multivariable analysis was utilized to assess the association between smoking status and risk of complications.



We identified 22,802 patients who underwent malignancy-related prostatectomy and met inclusion criteria. Based on reported smoking history, 2799 (12.3%) were current smokers, 1879 (8.2%) were former smokers, and 18,124 (79.5%) were never smokers. Current smokers had a higher rate of total complications (5.7%) in comparison with former (4.8%) and never smokers (4.6%; P = .050). Postoperative pneumonia was more frequent in current smokers (0.4%) compared with former smokers (0.2%) and never smokers (0.2%; P = .039). Unplanned intubation occurred more frequently in current smokers (0.4%) when compared with former smokers (0.3%) and never smokers (0.1%; P = .002). Multivariable analysis found that current smoking status was an independent predictor of an increased risk of unplanned intubation (odds ratio, 5.87; 95% confidence interval, 2.18-15.8; P < .001).



Smoking status influences the risk of postoperative complications following prostatectomy. Specifically, current smoking status is an independent predictor of unplanned intubation within 30 days of the procedure.
Weill Cornell Medical College, New York, NY.
David J
DJ
Byun
Weill Cornell Medical College, New York, NY.
Matthew R
MR
Cohn
Weill Cornell Medical College, New York, NY.
Samir N
SN
Patel
Department of Urology, UCLA Institute of Urologic Oncology, Los Angeles, CA.
Nicholas M
NM
Donin
Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland.
Roman
R
Sosnowski
Division of Urology, Department of Surgery, NYU Lutheran Medical Center, NYU Langone Heath System, Brooklyn, NY. Electronic address: marc.bjurlin@nyumc.org.
Marc A
MA
Bjurlin
D000368:Aged; D016208:Databases, Factual; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology*; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016896:Treatment Outcome
NSQIP; Postoperative complications; Prostate cancer; Smoking status; Surgical outcome