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Preoperative Smoking Habits and Postoperative Pulmonary Complications FREE TO VIEW

Leslie G. Bluman; Lori Mosca; Nancy Newman; David G. Simon
Author and Funding Information

Affiliations: From the Cancer Prevention, Detection and Control Research Program, Comprehensive Cancer Center, Duke University Medical Center, Durham, NC,  From the Preventive Cardiology Program, Division of Cardiology, The University of Michigan, Ann Arbor,  From the SUNY Health Science Center at Syracuse, Syracuse, NY.,  From the Community General Hospital, Syracuse, NY.

Affiliations: From the Cancer Prevention, Detection and Control Research Program, Comprehensive Cancer Center, Duke University Medical Center, Durham, NC,  From the Preventive Cardiology Program, Division of Cardiology, The University of Michigan, Ann Arbor,  From the SUNY Health Science Center at Syracuse, Syracuse, NY.,  From the Community General Hospital, Syracuse, NY.

Affiliations: From the Cancer Prevention, Detection and Control Research Program, Comprehensive Cancer Center, Duke University Medical Center, Durham, NC,  From the Preventive Cardiology Program, Division of Cardiology, The University of Michigan, Ann Arbor,  From the SUNY Health Science Center at Syracuse, Syracuse, NY.,  From the Community General Hospital, Syracuse, NY.

Affiliations: From the Cancer Prevention, Detection and Control Research Program, Comprehensive Cancer Center, Duke University Medical Center, Durham, NC,  From the Preventive Cardiology Program, Division of Cardiology, The University of Michigan, Ann Arbor,  From the SUNY Health Science Center at Syracuse, Syracuse, NY.,  From the Community General Hospital, Syracuse, NY.


1998 by the American College of Chest Physicians


Chest. 1998;113(4):883-889. doi:10.1378/chest.113.4.883
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Abstract

Objective: To examine the effect of preoperative smoking behavior on postoperative pulmonary complications.

Design: Prospective cohort study.

Setting: The Veterans Administration Medical Center, Syracuse, NY.

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

Measurements and 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.


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