Preoperative smoking habits and postoperative pulmonary complications
Preoperative smoking habits and postoperative pulmonary complications
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DOI：
10.1378/chest.113.4.883
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发表时间：
1998-04-01
期刊：
影响因子：
9.6
通讯作者：
Simon, DG
中科院分区：
文献类型：
--
作者：
Bluman, LG;Mosca, L;Simon, DG
目的：研究术前吸烟行为对术后肺部并发症的影响。设计：前瞻性队列研究。地点：退伍军人管理局医疗中心，锡拉丘兹，NY。参与者：计划进行非心脏择期手术的患者（n=410）。测量和结果：通过自我报告确定吸烟状态。通过系统提取病历资料确定术后肺部并发症。141例当前吸烟者中有31例（22.0%）发生术后肺部并发症，187例既往吸烟者中有24例（12.8%）发生术后肺部并发症，82例从不吸烟者中有4例（4.9%）发生术后肺部并发症。目前吸烟者与从不吸烟者发生术后肺部并发症的比值比（OR）为5.5（95%置信区间[CI]，1.9 - 16.2）和4.2（95% CI，1.2 - 14.8）调整手术类型、麻醉类型、胸片异常、慢性咳嗽、肺部疾病史、心脏病史后，COPD病史、教育水平、肺功能、体重指数和年龄。目前吸烟者谁报告减少吸烟量手术前更有可能发展的并发症相比，那些谁没有（调整OR=6.7，95%CI，2.6至17.1）。结论：目前吸烟与近6倍的风险增加术后肺部并发症。手术后1个月内减少吸烟与术后肺部并发症风险降低无关。
Objective: To examine the effect of preoperative smoking behavior on postoperative pulmonary complications.Design: Prospective cohort study.Setting: The Veterans Administration Medical Center, Syracuse, NY.Participants: Patients scheduled for noncardiac elective surgery (n=410).Measurements ana results: Smoking status was determined by self-report. Postoperative pulmonary complications were determined by systematic extraction of medical record data. Postoperative pulmonary complications occurred in 31 of 141 (22.0%) current smokers, 24 of 187 (12.8%) past smokers, and 4 of 82 (4.9%) never smokers. The odds ratio (OR) for developing a postoperative pulmonary complication for current smokers vs never smokers was 5.5 (95% confidence interval [CI], 1.9 to 16.2) and 4.2 (95% CI, 1.2 to 14.8) after adjustment for type of surgery, type of anesthesia, abnormal chest radiograph, chronic cough, history of pulmonary disease, history of cardiac disease, history of COPD, education level, pulmonary function, body mass index, and age. Current smokers who reported reducing cigarette consumption prior to surgery were more likely to develop a complication compared with those who did not (adjusted OR=6.7, 95% CI, 2.6 to 17.1).Conclusions: Current smoking was associated with a nearly sixfold increase in risk for a postoperative pulmonary complication. Reduction in smoking within 1 month of surgery was not associated with a decreased risk of postoperative pulmonary complications.