Alsanad Mohammed, Aljanoubi Mohammed, Alenezi Faraj K, Farley Amanda, Naidu Babu, Yeung Joyce
College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Perioper Med (Lond). 2025 Jan 10;14(1):5. doi: 10.1186/s13741-024-00479-4.
Smoking is the leading single cause of preventable death in England and also increases the risk of postoperative complications. The preoperative period is a potential opportunity to introduce smoking cessation interventions to smokers to reduce the risk of postoperative complications. A systematic search was conducted to find all studies that investigated the effectiveness of preoperative smoking cessation interventions. The primary outcome was smoking cessation at surgical time to the last follow-up, and the secondary outcome was postoperative complications that required treatment or ICU admission. A random-effects meta-analysis was used to synthesize the outcomes. Sixteen studies were included in the review (3505 participants), and 14 studies were included in the meta-analysis (2940 randomized participants). The quality of evidence was moderate due to the high risk of bias and heterogeneity. We found that patients who were provided with a smoking cessation intervention had significantly increased odds of quitting smoking by the time of surgery compared with usual care, with a reported relative risk (95% CI) 1.64 (1.30-2.07) and at the longest follow-ups with RR (95% CI) 1.38 (1.12-1.70). Moreover, there was no difference found in the rate of postoperative complications between intervention and control conditions with RR (95% CI) 0.81 (0.62-1.06). The use of standardized outcome measurements is recommended to reduce heterogeneity for future studies, and further investigation focusing on patient perspectives is needed.
PROSPERO CRD42023423202.
吸烟是英格兰可预防死亡的首要单一原因，还会增加术后并发症的风险。术前阶段是向吸烟者引入戒烟干预措施以降低术后并发症风险的潜在时机。我们进行了系统检索，以查找所有调查术前戒烟干预措施有效性的研究。主要结局是手术时到最后一次随访期间的戒烟情况，次要结局是需要治疗或入住重症监护病房（ICU）的术后并发症。采用随机效应荟萃分析来综合各项结局。该综述纳入了16项研究（3505名参与者），荟萃分析纳入了14项研究（2940名随机分组参与者）。由于存在高偏倚风险和异质性，证据质量为中等。我们发现，与常规护理相比，接受戒烟干预的患者在手术时戒烟的几率显著增加，报告的相对风险（95%置信区间）为1.64（1.30 - 2.07），在最长随访期时相对风险（95%置信区间）为1.38（1.12 - 1.70）。此外，干预组和对照组之间的术后并发症发生率没有差异，相对风险（95%置信区间）为0.81（0.62 - 1.06）。建议使用标准化结局测量方法以减少未来研究中的异质性，并且需要进一步关注患者观点的调查。
PROSPERO CRD42023423202。
