Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.
Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Int Wound J. 2023 Feb;20(2):391-402. doi: 10.1111/iwj.13887. Epub 2022 Jul 9.
Cigarette smoking is associated with surgical complications, including wound healing and surgical site infection. However, the association between smoking status and postoperative wound complications is not completely understood. Our objective was to investigate the effect of smoking on postoperative wound complications for major surgeries. Data were collected from the 2013 to 2018 participant use files of the American College of Surgeons National Surgical Quality Improvement Program database. A propensity score matching procedure was used to create the balanced smoker and nonsmoker groups. Multivariable logistic regression was used to calculate the odds ratios (ORs) with 95% confidence intervals (CIs) for postoperative wound complications, pulmonary complications, and in-hospital mortality associated with smokers. A total of 1 156 002 patients (578 001 smokers and 578 001 nonsmokers) were included in the propensity score matching analysis. Smoking was associated with a significantly increased risk of postoperative wound disruption (OR 1.65, 95% CI 1.56-1.75), surgical site infection (OR 1.31, 95% CI 1.28-1.34), reintubation (OR 1.47, 95% CI 1.40-1.54), and in-hospital mortality (OR 1.13, 95% CI 1.07-1.19) compared with nonsmoking. The length of hospital stay was significantly increased in smokers compared with nonsmokers. Our analysis indicates that smoking is associated with an increased risk of surgical site infection, wound disruption, and postoperative pulmonary complications. The results may drive the clinicians to encourage patients to quit smoking before surgery.
吸烟与手术并发症有关，包括伤口愈合和手术部位感染。然而，吸烟状况与术后伤口并发症之间的关系尚不完全清楚。我们的目的是研究吸烟对重大手术术后伤口并发症的影响。数据来自美国外科医师学会国家手术质量改进计划数据库 2013 年至 2018 年的参与者使用文件。使用倾向评分匹配程序创建平衡的吸烟者和非吸烟者组。多变量逻辑回归用于计算与吸烟者相关的术后伤口并发症、肺部并发症和住院死亡率的优势比（OR）及其 95%置信区间（CI）。共纳入 1156002 例患者（578001 例吸烟者和 578001 例非吸烟者）进行倾向评分匹配分析。吸烟与术后伤口破裂（OR 1.65，95%CI 1.56-1.75）、手术部位感染（OR 1.31，95%CI 1.28-1.34）、重新插管（OR 1.47，95%CI 1.40-1.54）和住院死亡率（OR 1.13，95%CI 1.07-1.19）显著增加相关。与非吸烟者相比，吸烟者的住院时间明显延长。我们的分析表明，吸烟与手术部位感染、伤口破裂和术后肺部并发症的风险增加有关。这些结果可能促使临床医生鼓励患者在手术前戒烟。
