Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Section of Cardiac Surgery, The University of Chicago Biological Sciences, Chicago, IL, USA.
Artif Organs. 2020 Jul;44(7):693-699. doi: 10.1111/aor.13660. Epub 2020 Feb 26.
Despite the well-established correlation between the tobacco use and cardiovascular disease, little is known about postoperative outcomes following the left ventricular assist device (LVAD) implantation. We aimed to elucidate the effect of tobacco smoking on post-LVAD implant outcomes. Patients who received LVADs from 2013 to 2018 were retrospectively characterized as current, former, or never smokers at the time of implant. We examined 1-year survival, total hospital readmissions, and specific hospital readmissions for LVAD-related adverse events based on patient's smoking status. Of the enrolled patients (n = 292), 55% were former smokers, 33% were never smokers, and 11% were current smokers. The majority of patients were African-American (48%) with a median age of 58 years. Never smokers were younger and less likely to be Caucasian compared to former or current smokers (P < .05, for both). The category of former smokers had statistically comparable total readmission rates with never smokers (2.49 vs. 2.13 event/year), whereas current smokers had significantly higher rates compared to never smokers (2.81 events/year, P < .05), with odds ratio 2.12 (95% CI = 1.35-3.32) adjusted for age and Caucasian race for >5 times of total readmissions per year. The rates of driveline infection, stroke, and hemolysis were statistically comparable between the never smokers and former smokers, while current smokers had significantly higher rates compared to never smokers (P < .05 for all).
尽管吸烟与心血管疾病之间存在明确的相关性，但对于左心室辅助装置（LVAD）植入后的术后结果知之甚少。我们旨在阐明吸烟对 LVAD 植入后结局的影响。2013 年至 2018 年接受 LVAD 的患者，根据植入时的吸烟状况，被分为当前吸烟者、曾经吸烟者或从不吸烟者。我们根据患者的吸烟状况，检查了 1 年生存率、总住院再入院率和与 LVAD 相关不良事件的特定住院再入院率。在纳入的患者（n=292）中，55%为曾经吸烟者，33%为从不吸烟者，11%为当前吸烟者。大多数患者为非裔美国人（48%），中位年龄为 58 岁。与曾经吸烟者或当前吸烟者相比，从不吸烟者更年轻，且更不可能为白人（均 P<0.05）。曾经吸烟者的总再入院率与从不吸烟者统计学上可比（2.49 与 2.13 次/年），而当前吸烟者的再入院率明显高于从不吸烟者（2.81 次/年，P<0.05），调整年龄和白种人种族后，比值比为 2.12（95%CI=1.35-3.32），每年总再入院次数超过 5 次。在感染、中风和溶血方面，从不吸烟者和曾经吸烟者的发生率无统计学差异，而当前吸烟者的发生率明显高于从不吸烟者（所有比较 P<0.05）。
