Study Finds Smokers' Surgical Outcomes Riddled with Severe Complications and Even Death

Results from a clinical study presented at ANESTHESIOLOGY 2010 found that smokers have significantly more complications post-surgery than non-smokers, including a higher death rate.

"Previous research told us that comprehensive warnings about the dangers of tobacco can change attitudes towards smoking, especially among patients coming in for surgery," said Alparslan Turan, M.D., lead study investigator, Associate Professor, Department of Outcomes Research, Cleveland Clinic. "The preoperative period is an excellent time to address the health risks associated with smoking, using it as a teachable moment."

Some of the increased incidence of adverse outcomes among smokers the study found included:

• Smokers were 40 percent more likely to develop major complications and die within 30 days of surgery.
• Smokers had an increased risk for respiratory complications.
• Pneumonia risk was doubled among smokers.
• Smokers were 87 percent more likely to experience unplanned intubation (a tube inserted in the patient’s throat to help him/her breathe).
• Smokers were 53 percent more likely to require artificial mechanical ventilation that lasted more than 48 hours after surgery.

Smokers also saw a significant increase in cardiovascular complications and were:

• 57 percent more likely to experience cardiac arrest
• 80 percent more likely to have a heart attack
• 73 percent more likely to have a stroke

Surgical site complications were also higher among smokers. They were:

• 30-42 percent more likely to have a surgical site infection
• There was a 30 percent increase in the risk for serious systemic infections such as sepsis.

"Another key finding of the study is that the more a patient smoked, the more complications he/she was likely to experience," said Dr. Turan.

About the Study
The Cleveland Clinic researchers evaluated 635,265 patients from the American College of Surgeons National Surgical Quality Improvement Program database. There were over 200 participating centers prospectively collecting data with standardized methods that provided researchers a vast amount of data to overcome many of the limitations of previous studies, and results represent the current situation in the United States. The study compared 82,304 smokers with 82,304 non-smoking patients who had similar surgical procedures and similar preoperative risk factors using sophisticated statistical techniques.

For more information on ASA’s smoking cessation program and resources, please visit http://www.lifelinetomodernmedicine.com/ArticlePage.aspx?ID=bdb9051f-97a4-48bd-9167-5069717fbc95&LandingID=fc6eb1da-98e4-43c7-bb9f-09c17e2a005d.