吸烟对颈椎前路椎体次全切除术后围手术期结果和假关节形成的影响：临床文章。
The effects of smoking on perioperative outcomes and pseudarthrosis following anterior cervical corpectomy: Clinical article.
机构信息
Department of Neurological Surgery, University of San Francisco, California.
出版信息
J Neurosurg Spine. 2014 Oct;21(4):547-58. doi: 10.3171/2014.6.SPINE13762. Epub 2014 Jul 11.
OBJECT
Smoking is one of the leading causes of preventable morbidity and death in the U.S. and has been associated with perioperative complications. In this study, the authors examined the effects of smoking on perioperative outcomes and pseudarthrosis rates following anterior cervical corpectomy.
METHODS
All adult patients from 2006 to 2011 who underwent anterior cervical corpectomy were identified. Patients were categorized into 3 groups: patients who never smoked (nonsmokers), patients who quit for at least 1 year (quitters), and patients who continue to smoke (current smokers). Demographic, medical, and surgical covariates were collected. Multivariate analysis was used to define the relationship between smoking and blood loss, 30-day complications, length of hospital stay, and pseudarthrosis.
RESULTS
A total of 160 patients were included in the study. Of the 160 patients, 49.4% were nonsmokers, 25.6% were quitters, and 25.0% were current smokers. The overall 30-day complication rate was 20.0%, and pseudarthrosis occurred in 7.6% of patients. Mean blood loss was 368.3 ml and mean length of stay was 6.5 days. Current smoking status was significantly associated with higher complication rates (p < 0.001) and longer lengths of stay (p < 0.001); current smoking status remained an independent risk factor for both outcomes after multivariate logistic regression analysis. The complications that were experienced in current smokers were mostly infections (76.5%), and this proportion was significantly greater than in nonsmokers and quitters (p = 0.013). Current smoking status was also an independent risk factor for pseudarthrosis at 1-year follow-up (p = 0.012).
CONCLUSIONS
Smoking is independently associated with higher perioperative complications (especially infectious complications), longer lengths of stay, and higher rates of pseudarthrosis in patients undergoing anterior cervical corpectomy.
目的
吸烟是美国可预防发病率和死亡率的主要原因之一，并与围手术期并发症有关。在这项研究中，作者研究了吸烟对颈椎前路椎体切除术围手术期结果和假关节发生率的影响。
方法
从 2006 年至 2011 年，确定所有接受颈椎前路椎体切除术的成年患者。患者分为 3 组：从不吸烟的患者（非吸烟者）、至少戒烟 1 年的患者（戒烟者）和继续吸烟的患者（吸烟者）。收集了人口统计学、医学和手术相关的协变量。采用多变量分析定义吸烟与失血量、30 天并发症、住院时间和假关节之间的关系。
结果
共有 160 名患者纳入本研究。在 160 名患者中，49.4%为非吸烟者，25.6%为戒烟者，25.0%为吸烟者。总的 30 天并发症发生率为 20.0%，7.6%的患者发生假关节。平均失血量为 368.3ml，平均住院时间为 6.5 天。当前吸烟状况与更高的并发症发生率（p<0.001）和更长的住院时间（p<0.001）显著相关；多元逻辑回归分析后，当前吸烟状态仍然是这两个结果的独立危险因素。吸烟者经历的并发症主要是感染（76.5%），这一比例明显高于非吸烟者和戒烟者（p=0.013）。当前吸烟状态也是颈椎前路椎体切除术后 1 年发生假关节的独立危险因素（p=0.012）。
结论
吸烟与颈椎前路椎体切除术患者围手术期并发症（特别是感染性并发症）增加、住院时间延长和假关节发生率增加独立相关。
Zotero 插件