Smoking Status and Outcomes following Lung Resection.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Thoracic and Cardiovascular Surgeon Pub Date : 2024-04-01 Epub Date: 2023-08-25 DOI:10.1055/a-2160-5091
Amber Ahmed-Issap, Kim Mantio, Shubham Jain, Akolade Habib, Andrew Brazier, Marko Raseta, Udo Abah
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引用次数: 0

Abstract

Background:  Surgical resection is the gold standard treatment for the management of early-stage lung cancer. Several modifiable factors may significantly influence postoperative morbidity and mortality. We examined the outcomes of patients following lung resection based upon preoperative smoking status to quantify the impact on postoperative outcomes.

Methods:  Data from consecutive lung resections from January 1, 2012 to June 11, 2021 were included. Biopsies for interstitial lung disease and resections for emphysematous lung or bullae were excluded. Patients were divided into three cohorts: current smokers (those who smoked within 4 weeks of surgery), ex-smokers (those who stopped smoking prior to 4 weeks leading up to surgery), and nonsmokers (those who have never smoked). Patient's preoperative variables, postoperative complications, length of stay, and mortality were examined.

Results:  A total of 2,426 patients were included in the study. A total of 502 patients (20.7%) were current smokers, 1,445 (59.6%) were ex-smokers and 479 patients (19.7%) nonsmokers. Of those smoking immediately prior to surgery 36.9% developed postoperative complications. Lower respiratory tract infections (18.1%) and prolonged air leak (17.1%), in particular, were significant higher in smokers. 90-day mortality (5.8%) was higher in the current smokers when compared with ex- and nonsmokers (5.3 and 1%, respectively). Median length of hospital stay, readmissions, and cost of hospital stay was also higher in the current smoker cohort.

Conclusion:  Smoking immediately prior to surgery is associated with an increase in morbidity, mortality, and length of stay. Not only does this have a significant individual impact, but it is also associated with a significant financial burden to the National Health Service.

肺切除术后的吸烟状况和结果。
背景: 手术切除是早期癌症治疗的金标准。几个可改变的因素可能会显著影响术后的发病率和死亡率。我们根据术前吸烟状况检查了肺切除术后患者的预后,以量化对术后预后的影响。方法: 包括2012年1月1日至2021年6月11日连续肺切除的数据。排除间质性肺病的活检和肺气肿或大泡的切除。患者被分为三组:当前吸烟者(手术后4周内吸烟的人)、前吸烟者(手术前4周前戒烟的人)和非吸烟者(从未吸烟的人。检查患者的术前变量、术后并发症、住院时间和死亡率。结果: 本研究共纳入2426名患者。共有502名患者(20.7%)是目前吸烟者,1445名患者(59.6%)是前吸烟者,479名患者(19.7%)是非吸烟者。在手术前吸烟的患者中,36.9%出现了术后并发症。尤其是下呼吸道感染(18.1%)和长期漏气(17.1%)在吸烟者中明显更高。目前吸烟者的90天死亡率(5.8%)高于前吸烟者和非吸烟者(分别为5.3%和1%)。在当前吸烟者队列中,住院时间、再入院次数和住院费用的中位数也较高。结论: 手术前吸烟会增加发病率、死亡率和住院时间。这不仅对个人产生了重大影响,而且也给国家卫生服务带来了重大的财政负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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