TY - JOUR
T1 - Preoperative Smoking Status and Postoperative Complications
T2 - A Systematic Review and Meta-analysis
AU - Pedersen, Marie Grønkjær
AU - Eliasen, Marie
AU - Skov-Ettrup, Lise Skrubbeltrang
AU - Tolstrup, Janne Schurmann
AU - Christiansen, Anne Hjøllund
AU - Mikkelsen, Stine Schou
AU - Becker, Ulrik
AU - Flensborg-Madsen, Trine
PY - 2014/1
Y1 - 2014/1
N2 - OBJECTIVE: To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type. BACKGROUND: The conclusions of studies examining the association between preoperative smoking and postoperative complications are inconsistent, thus there is a need for a review and meta-analysis to summarize the existing evidence. METHODS: A systematic review and meta-analysis based on a search in MEDLINE, EMBASE, CINAHL, and PsycINFO. Included were original studies of the association between smoking status and postoperative complications occurring within 30 days of operation. In total, 9354 studies were identified and reviewed for eligibility and data were extracted. Forest plots and summarized relative risks (RR) including 95% confidence intervals (CIs) were estimated for various complication types. RESULTS: Of the 9354 identified studies, 107 studies were included in the meta-analyses and based on these, 157 data sets were extracted. Preoperative smoking was associated with an increased risk of various postoperative complications including general morbidity (RR = 1.52, 95% CI: 1.33-1.74), wound complications (RR = 2.15, 95% CI: 1.87-2.49), general infections (RR = 1.54, 95% CI: 1.32-1.79), pulmonary complications (RR = 1.73, 95% CI: 1.35-2.23), neurological complications (RR = 1.38, 95% CI: 1.01-1.88), and admission to intensive care unit (RR = 1.60, 95% CI: 1.14-2.25). Preoperative smoking status was not observed to be associated with postoperative mortality, cardiovascular complications, bleedings, anastomotic leakage, or allograft rejection. CONCLUSIONS: Preoperative smoking was found to be associated with an increased risk of the following postoperative complications: general morbidity, wound complications, general infections, pulmonary complications, neurological complications, and admission to the intensive care unit.
AB - OBJECTIVE: To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type. BACKGROUND: The conclusions of studies examining the association between preoperative smoking and postoperative complications are inconsistent, thus there is a need for a review and meta-analysis to summarize the existing evidence. METHODS: A systematic review and meta-analysis based on a search in MEDLINE, EMBASE, CINAHL, and PsycINFO. Included were original studies of the association between smoking status and postoperative complications occurring within 30 days of operation. In total, 9354 studies were identified and reviewed for eligibility and data were extracted. Forest plots and summarized relative risks (RR) including 95% confidence intervals (CIs) were estimated for various complication types. RESULTS: Of the 9354 identified studies, 107 studies were included in the meta-analyses and based on these, 157 data sets were extracted. Preoperative smoking was associated with an increased risk of various postoperative complications including general morbidity (RR = 1.52, 95% CI: 1.33-1.74), wound complications (RR = 2.15, 95% CI: 1.87-2.49), general infections (RR = 1.54, 95% CI: 1.32-1.79), pulmonary complications (RR = 1.73, 95% CI: 1.35-2.23), neurological complications (RR = 1.38, 95% CI: 1.01-1.88), and admission to intensive care unit (RR = 1.60, 95% CI: 1.14-2.25). Preoperative smoking status was not observed to be associated with postoperative mortality, cardiovascular complications, bleedings, anastomotic leakage, or allograft rejection. CONCLUSIONS: Preoperative smoking was found to be associated with an increased risk of the following postoperative complications: general morbidity, wound complications, general infections, pulmonary complications, neurological complications, and admission to the intensive care unit.
U2 - 10.1097/SLA.0b013e3182911913
DO - 10.1097/SLA.0b013e3182911913
M3 - Review
C2 - 23799418
SN - 0003-4932
VL - 259
SP - 52
EP - 71
JO - Advances in Surgery
JF - Advances in Surgery
IS - 1
ER -