Gali Kathleen, Spaderna Heike, Smits Jacqueline M A, Bramstedt Katrina A, Weidner Gerdi
Department of Public Health, University of California, Merced, CA, USA.
Department of Health Psychology, Trier University, Trier, Germany.
Prog Transplant. 2016 Jun;26(2):117-21. doi: 10.1177/1526924816640687. Epub 2016 Apr 6.
We examined the association of smoking status at time of listing with waitlist mortality among heart transplant (HTx) candidates.
Data were analyzed from 316 participants (aged 53 ± 11; 18% female) of the Waiting for a New Heart Study, a prospective observational study of patients newly listed for HTx at 17 hospitals.
During the study period (April 2005 to March 2010), 14% of those who never smoked died, 18% among former smokers died, and almost half (42%) died among those who reported smoking at time of wait listing. Multivariate Cox regression models controlling for age, sex, and disease severity revealed smoking at time of listing was associated with significantly higher risk of mortality compared to never smoking (hazard ratio [HR] = 3.43; P = .03). The relationship between smoking and mortality risk appeared to follow a dose-dependent pattern: adjusted HRs were 1.80 for those who quit ≤1 year ago, 1.25 for those who quit >1 to 10 years ago, and 0.90 for those quit >10 years ago, compared to never smokers. Smoking at time of listing may increase risk of mortality during the waiting period, indicating the need for improved strategies to achieve smoking cessation as early as possible in the course of HTx.
我们研究了心脏移植（HTx）候选者登记时的吸烟状况与等待名单上死亡率之间的关联。
对“等待新心脏研究”的316名参与者（年龄53±11岁；18%为女性）的数据进行了分析，该研究是对17家医院新登记接受HTx的患者进行的一项前瞻性观察性研究。
在研究期间（2005年4月至2010年3月），从不吸烟者中有14%死亡，既往吸烟者中有18%死亡，而在登记等待时报告仍在吸烟的人中，近一半（42%）死亡。控制年龄、性别和疾病严重程度的多变量Cox回归模型显示，与从不吸烟相比，登记时吸烟与显著更高的死亡风险相关（风险比[HR]=3.43；P=0.03）。吸烟与死亡风险之间的关系似乎呈剂量依赖性模式：与从不吸烟者相比，≤1年前戒烟者的调整后HR为1.80，>1至10年前戒烟者为1.25，>10年前戒烟者为0.90。登记时吸烟可能会增加等待期间的死亡风险，这表明需要改进策略，以便在HTx过程中尽早实现戒烟。
