Cargando…

Increased Surgical Complications in Smokers Undergoing Radical Cystectomy(1)

BACKGROUND: Not only is smoking a risk factor for the development of bladder cancer, it has also been implicated in increasing surgical morbidity and mortality. In general, the demographic and clinical characteristics of smokers are different to non-smokers which can bias the results of the impact o...

Descripción completa

Detalles Bibliográficos
Autores principales: Sathianathen, Niranjan J., Weight, Christopher J., Jarosek, Stephanie L., Konety, Badrinath R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218107/
https://www.ncbi.nlm.nih.gov/pubmed/30417051
http://dx.doi.org/10.3233/BLC-180185
_version_ 1783368403419922432
author Sathianathen, Niranjan J.
Weight, Christopher J.
Jarosek, Stephanie L.
Konety, Badrinath R.
author_facet Sathianathen, Niranjan J.
Weight, Christopher J.
Jarosek, Stephanie L.
Konety, Badrinath R.
author_sort Sathianathen, Niranjan J.
collection PubMed
description BACKGROUND: Not only is smoking a risk factor for the development of bladder cancer, it has also been implicated in increasing surgical morbidity and mortality. In general, the demographic and clinical characteristics of smokers are different to non-smokers which can bias the results of the impact of smoking. OBJECTIVE: To evaluate the impact of smoking on radical cystectomy outcomes. METHODS: Radical cystectomy cases were identified in the National Surgical Quality Improvement Program database from 2007–2015. Smokers were matched with non-smokers using propensity scores in a 1:1 ratio. Multivariate logistic regression was performed to evaluate the overall incidence of Clavien III-V complications. Secondary analysis was performed for the incidence of each complication recorded in NSQIP. RESULTS: A total of 850 smokers undergoing radical cystectomy were matched to 850 non-smokers. The matching process improved the balance of covariates between smokers and non-smokers. The overall incidence of Clavien III-V complications was higher in smokers (13.1% vs 7.4%, p < 0.001). This corresponded to an adjusted odds ratio of 1.9 [95% CI 1.4–2.6, p = 0.028]. Other comorbid conditions worsened post-operative complications amongst smokers. When evaluating each complication recorded in the database, smokers had a higher incidence of wound dehiscence, pneumonia and myocardial infarction. CONCLUSION: Current smokers have a greater risk of morbidity following radical cystectomy. This should be considered when evaluating safety of surgery and patients should be counselled accordingly. Furthermore, even a short period of pre-operative smoking cessation can improve surgical outcomes.
format Online
Article
Text
id pubmed-6218107
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher IOS Press
record_format MEDLINE/PubMed
spelling pubmed-62181072018-11-07 Increased Surgical Complications in Smokers Undergoing Radical Cystectomy(1) Sathianathen, Niranjan J. Weight, Christopher J. Jarosek, Stephanie L. Konety, Badrinath R. Bladder Cancer Research Report BACKGROUND: Not only is smoking a risk factor for the development of bladder cancer, it has also been implicated in increasing surgical morbidity and mortality. In general, the demographic and clinical characteristics of smokers are different to non-smokers which can bias the results of the impact of smoking. OBJECTIVE: To evaluate the impact of smoking on radical cystectomy outcomes. METHODS: Radical cystectomy cases were identified in the National Surgical Quality Improvement Program database from 2007–2015. Smokers were matched with non-smokers using propensity scores in a 1:1 ratio. Multivariate logistic regression was performed to evaluate the overall incidence of Clavien III-V complications. Secondary analysis was performed for the incidence of each complication recorded in NSQIP. RESULTS: A total of 850 smokers undergoing radical cystectomy were matched to 850 non-smokers. The matching process improved the balance of covariates between smokers and non-smokers. The overall incidence of Clavien III-V complications was higher in smokers (13.1% vs 7.4%, p < 0.001). This corresponded to an adjusted odds ratio of 1.9 [95% CI 1.4–2.6, p = 0.028]. Other comorbid conditions worsened post-operative complications amongst smokers. When evaluating each complication recorded in the database, smokers had a higher incidence of wound dehiscence, pneumonia and myocardial infarction. CONCLUSION: Current smokers have a greater risk of morbidity following radical cystectomy. This should be considered when evaluating safety of surgery and patients should be counselled accordingly. Furthermore, even a short period of pre-operative smoking cessation can improve surgical outcomes. IOS Press 2018-10-29 /pmc/articles/PMC6218107/ /pubmed/30417051 http://dx.doi.org/10.3233/BLC-180185 Text en © 2018 – IOS Press and the authors. All rights reserved https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Report
Sathianathen, Niranjan J.
Weight, Christopher J.
Jarosek, Stephanie L.
Konety, Badrinath R.
Increased Surgical Complications in Smokers Undergoing Radical Cystectomy(1)
title Increased Surgical Complications in Smokers Undergoing Radical Cystectomy(1)
title_full Increased Surgical Complications in Smokers Undergoing Radical Cystectomy(1)
title_fullStr Increased Surgical Complications in Smokers Undergoing Radical Cystectomy(1)
title_full_unstemmed Increased Surgical Complications in Smokers Undergoing Radical Cystectomy(1)
title_short Increased Surgical Complications in Smokers Undergoing Radical Cystectomy(1)
title_sort increased surgical complications in smokers undergoing radical cystectomy(1)
topic Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218107/
https://www.ncbi.nlm.nih.gov/pubmed/30417051
http://dx.doi.org/10.3233/BLC-180185
work_keys_str_mv AT sathianathenniranjanj increasedsurgicalcomplicationsinsmokersundergoingradicalcystectomy1
AT weightchristopherj increasedsurgicalcomplicationsinsmokersundergoingradicalcystectomy1
AT jarosekstephaniel increasedsurgicalcomplicationsinsmokersundergoingradicalcystectomy1
AT konetybadrinathr increasedsurgicalcomplicationsinsmokersundergoingradicalcystectomy1