Impact of short duration smoking cessation on post-operative complications: A systematic review and meta-analysis

IF 5.1 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2025-08-20 DOI:10.1016/j.jclinane.2025.111967

Evan Tang MD , Ray Martinez Rodriguez BScN BSc , Ananya Srivastava MD , Roshan Malhan MD , Isabelle Laksono MD , Ellene Yan , Marina Englesakis MLIS , Jean Wong MD , Frances Chung MD

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引用次数: 0

Abstract

Background

Use of tobacco poses significant health risks, particularly in surgical patients, where smoking is a well-established risk factor for postoperative complications. Patients are often seen in the pre-assessment clinic 2–4 weeks prior to surgery, presenting a window of opportunity to intervene. The objective of our systematic review and meta-analysis is to explore the impact of short-term smoking cessation on postoperative outcomes, focusing on the critical 2–4-week period preceding surgery.

Design

Systematic review and meta-analysis.

Setting

MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews.

Patients

Adults undergoing surgical procedures with a defined smoking cessation pre-operative smoking cessation interval.

Measurement

Post-operative complications including pulmonary complications, surgical site infection, wound complication, bleeding, mortality, and composite complications.

Results

Fifty-five studies were included in the systematic review and meta-analysis. Pulmonary complications were more prevalent in former smokers compared to non-smokers, even after cessation. Progressively longer smoking cessation periods showed improved outcomes. Compared to active smokers, preoperative cessation reduced pulmonary complications by 27 % at ≥2 weeks (RR 0.73, 95 % CI 0.60–0.89), 29 % at ≥4 weeks (RR 0.71, 95 % CI 0.61–0.82), and 37 % at ≥8 weeks (RR 0.63, 95 % CI 0.41–0.95). With ≥4 weeks of cessation, there was a 33 % lower risk of wound complications (RR 0.67, 95 % CI 0.47–0.94), 31 % lower risk of composite complications (RR 0.69, 95 %CI 0.63–0.76), and 14 % lower risk of mortality (RR 0.86, 95 % CI 0.77–0.97). Short term cessation did not seem to have a significant impact on surgical site infections or bleeding.

Conclusions

Short term cessation of at least 2–4 weeks demonstrates benefits in reducing post-operative complications.

Abstract Image

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短期戒烟对术后并发症的影响：一项系统回顾和荟萃分析

背景：使用烟草会造成重大的健康风险，特别是在外科手术患者中，吸烟是一个公认的术后并发症危险因素。患者通常在手术前2-4周到预评估诊所就诊，这为干预提供了机会。我们的系统综述和荟萃分析的目的是探讨短期戒烟对术后预后的影响，重点关注手术前关键的2 - 4周。设计系统回顾和荟萃分析。设置medline， Embase， Cochrane中央对照试验注册库和Cochrane系统评价数据库。接受外科手术且术前有明确戒烟间隔的成人患者。术后并发症包括肺部并发症、手术部位感染、伤口并发症、出血、死亡率和复合并发症。结果系统评价和荟萃分析共纳入55项研究。与不吸烟者相比，前吸烟者的肺部并发症更为普遍，即使在戒烟后也是如此。逐渐延长的戒烟期显示出更好的结果。与活跃吸烟者相比，术前戒烟在≥2周时减少了27%的肺部并发症（RR 0.73, 95% CI 0.60-0.89），≥4周时减少了29% (RR 0.71, 95% CI 0.61-0.82)，≥8周时减少了37% （RR 0.63, 95% CI 0.41-0.95）。戒烟≥4周，伤口并发症风险降低33% (RR 0.67, 95% CI 0.47-0.94)，复合并发症风险降低31% (RR 0.69, 95% CI 0.63-0.76)，死亡风险降低14% （RR 0.86, 95% CI 0.77-0.97）。短期停止似乎对手术部位感染或出血没有显著影响。结论短期停药至少2-4周可减少术后并发症。

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

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.