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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
IOS Press
2018
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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 |
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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 |
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