Smoking increases the risk of postoperative wound complications: A propensity score‐matched cohort study
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 postoperativ...
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| Veröffentlicht in: | International wound journal 2023-02, Vol.20 (2), p.391-402 |
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| creator | Fan Chiang, Yu‐Hsuan Lee, Yuan‐Wen Lam, Fai Liao, Chien‐Chang Chang, Chuen‐Chau Lin, Chao‐Shun |
| description | 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. |
| doi_str_mv | 10.1111/iwj.13887 |
| format | Article |
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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.</description><identifier>ISSN: 1742-4801</identifier><identifier>EISSN: 1742-481X</identifier><identifier>DOI: 10.1111/iwj.13887</identifier><identifier>PMID: 35808947</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Abstinence ; Anesthesia ; Body mass index ; Cancer ; Chronic obstructive pulmonary disease ; Classification ; Cohort analysis ; Cohort Studies ; Complications and side effects ; Diabetes ; Hemophilia ; Hospitals ; Humans ; Hypertension ; Infections ; Kidney diseases ; Length of stay ; Medical personnel ; Medical societies ; Mortality ; Original ; Patients ; postoperative complications ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Propensity Score ; Quality control ; Quality improvement ; Retrospective Studies ; Risk Factors ; Smokers ; Smoking ; Smoking - adverse effects ; Smoking cessation ; Steroids ; Surgical outcomes ; surgical site infection ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - etiology ; Thoracic surgery ; Ventilators ; wound dehiscence ; Wound Healing</subject><ispartof>International wound journal, 2023-02, Vol.20 (2), p.391-402</ispartof><rights>2022 The Authors. published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.</rights><rights>2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.</rights><rights>COPYRIGHT 2023 John Wiley & Sons, Inc.</rights><rights>2023. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5107-db59c178e4359a520daf77b700fc51801b4caa5c8a2431b076d38a35c67cca143</citedby><cites>FETCH-LOGICAL-c5107-db59c178e4359a520daf77b700fc51801b4caa5c8a2431b076d38a35c67cca143</cites><orcidid>0000-0002-5013-2912 ; 0000-0001-6964-3862</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9885463/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9885463/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1416,11561,27923,27924,45573,45574,46051,46475,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35808947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fan Chiang, Yu‐Hsuan</creatorcontrib><creatorcontrib>Lee, Yuan‐Wen</creatorcontrib><creatorcontrib>Lam, Fai</creatorcontrib><creatorcontrib>Liao, Chien‐Chang</creatorcontrib><creatorcontrib>Chang, Chuen‐Chau</creatorcontrib><creatorcontrib>Lin, Chao‐Shun</creatorcontrib><title>Smoking increases the risk of postoperative wound complications: A propensity score‐matched cohort study</title><title>International wound journal</title><addtitle>Int Wound J</addtitle><description>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.</description><subject>Abstinence</subject><subject>Anesthesia</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Classification</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Diabetes</subject><subject>Hemophilia</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Infections</subject><subject>Kidney diseases</subject><subject>Length of stay</subject><subject>Medical personnel</subject><subject>Medical societies</subject><subject>Mortality</subject><subject>Original</subject><subject>Patients</subject><subject>postoperative complications</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Propensity Score</subject><subject>Quality control</subject><subject>Quality improvement</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Smokers</subject><subject>Smoking</subject><subject>Smoking - adverse effects</subject><subject>Smoking cessation</subject><subject>Steroids</subject><subject>Surgical outcomes</subject><subject>surgical site infection</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Surgical Wound Infection - etiology</subject><subject>Thoracic surgery</subject><subject>Ventilators</subject><subject>wound dehiscence</subject><subject>Wound Healing</subject><issn>1742-4801</issn><issn>1742-481X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1ksFuEzEQhi1ERdvAgRdAlrjAIam9ttdeDkhRBbSoEgdAcLO8Xm_idNfe2t5GufUReEaepE5TAkXgOXg0_uYfjfUD8ByjGc7nxK5XM0yE4I_AEea0mFKBvz_e5wgfguMYVwgVFWP8CTgkTCBRUX4EVp97f2ndAlqng1HRRJiWBgYbL6Fv4eBj8oMJKtlrA9d-dA3Uvh86q3PJu_gGzuEQMuKiTRsYtQ_m582PXiW9NFt26UOCMY3N5ik4aFUXzbP7ewK-vn_35fRsevHpw_np_GKqGUZ82tSs0pgLQwmrFCtQo1rOa45Qm4G8TE21UkwLVVCCa8TLhghFmC651gpTMgFvd7rDWPem0caloDo5BNursJFeWfnwxdmlXPhrWQnBaEmywKt7geCvRhOT7G3UpuuUM36MsigF5wVFbDvr5V_oyo_B5fUkQRUqUVXy8je1UJ2R1rU-z9VbUTnnFBNGqhwTMPsHlaMxvdXemdbm-oOG17sGHXyMwbT7HTGSW2PIbAx5Z4zMvvjzU_bkLydk4GQHrPOUzf-V5Pm3jzvJW624xGE</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Fan Chiang, Yu‐Hsuan</creator><creator>Lee, Yuan‐Wen</creator><creator>Lam, Fai</creator><creator>Liao, Chien‐Chang</creator><creator>Chang, Chuen‐Chau</creator><creator>Lin, Chao‐Shun</creator><general>Blackwell Publishing Ltd</general><general>John Wiley & Sons, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5013-2912</orcidid><orcidid>https://orcid.org/0000-0001-6964-3862</orcidid></search><sort><creationdate>202302</creationdate><title>Smoking increases the risk of postoperative wound complications: A propensity score‐matched cohort study</title><author>Fan Chiang, Yu‐Hsuan ; 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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.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>35808947</pmid><doi>10.1111/iwj.13887</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-5013-2912</orcidid><orcidid>https://orcid.org/0000-0001-6964-3862</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abstinence Anesthesia Body mass index Cancer Chronic obstructive pulmonary disease Classification Cohort analysis Cohort Studies Complications and side effects Diabetes Hemophilia Hospitals Humans Hypertension Infections Kidney diseases Length of stay Medical personnel Medical societies Mortality Original Patients postoperative complications Postoperative Complications - epidemiology Postoperative Complications - etiology Propensity Score Quality control Quality improvement Retrospective Studies Risk Factors Smokers Smoking Smoking - adverse effects Smoking cessation Steroids Surgical outcomes surgical site infection Surgical Wound Infection - epidemiology Surgical Wound Infection - etiology Thoracic surgery Ventilators wound dehiscence Wound Healing |
| title | Smoking increases the risk of postoperative wound complications: A propensity score‐matched cohort study |
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