Adverse effects of smoking on postoperative outcomes in cancer patients.
Adverse effects of smoking on postoperative outcomes in cancer patients.
复制标题
吸烟对癌症患者术后结局的不利影响。
DOI：
10.1245/s10434-011-2128-y
复制
发表时间：
2012-05
影响因子：
3.7
通讯作者：
Houston T
中科院分区：
文献类型：
--
作者：
Gajdos C;Hawn MT;Campagna EJ;Henderson WG;Singh JA;Houston T
吸烟对癌症患者术后结局的可能负面影响尚未得到很好的研究。我们使用了2002-2008年的退伍军人管理局外科质量改进计划(VASQIP)数据库，该数据库评估了退伍军人管理局医疗系统内接受大手术的患者的术前风险因素和术后结果。与从不吸烟的人相比，既往吸烟者和患有胃肠道恶性肿瘤的吸烟者更容易发生手术部位感染(OR：1.25，95%CI：1.09-1.44)(OR：1.20，95%CI：1.05-1.38)、合并肺部并发症(CPO：肺炎、无法脱机、重新插管)(OR：1.60，95%CI：1.38-1.87)(OR：1.96，95%CI：1.68~2.29)和返回手术室(OR：1.20，95%CI：1.03~1.39)(OR：1.31，95%CI：1.13~1.53)。既往吸烟者和现在吸烟者在30天(OR：1.50，95%CI：1.19~1.89)(OR：1.41，95%CI：1.08~1.82)和1年(OR：1.22，95%CI：1.08~1.38)(OR：1.62，95%CI：1.43~1.85)的死亡率显著高于吸烟者。与非吸烟者相比，目前吸烟的胸部手术患者更容易发生CPO(OR：1.62，95%CI：1.25~2.11)和一年内死亡率(OR：1.50，95%CI：1.17~1.92)，但SSI发生率不受吸烟状况的影响。与既往吸烟者相比，现在的吸烟者术后住院时间显著增加(总体4.3%[p<；0.001]，胃肠道4.7%[p=0.003]，胸部9.0%[p<；0.001])。既往和现在的吸烟状况是退伍军人胃肠道癌症和胸部手术后主要术后并发症和死亡率的重要危险因素。退伍军人中所有重大癌症手术前应鼓励戒烟，以减少术后并发症和住院时间。
The possible negative effects of smoking on postoperative outcomes have not been well-studied in cancer patients. We used the VA Surgical Quality Improvement Program (VASQIP) database for the years 2002–2008, which assesses pre-operative risk factors and post-operative outcomes for patients undergoing major surgery within the VA healthcare system. Compared to never smokers, prior smokers and current smokers with GI malignancies were significantly more likely to have surgical site infection (SSI)( Odds ratio, OR:1.25, 95%CI:1.09–1.44)(OR:1.20, 95%CI:1.05–1.38), combined pulmonary complications (CPO: pneumonia, failure to wean from ventilator, reintubation) (OR:1.60, 95%CI:1.38–1.87)(OR:1.96, 95%CI:1.68–2.29) and return to the operating room (OR:1.20, 95%CI:1.03–1.39)(OR:1.31 95%CI:1.13–1.53), respectively. Both prior and current smokers had a significantly higher mortality at 30 days (OR:1.50, 95%CI:1.19–1.89)(OR: 1.41, 95%CI:1.08–1.82) and one year (OR:1.22, 95%CI:1.08–1.38)(OR:1.62, 95%C I:1.43–1.85). Thoracic surgery patients who were current smokers were more likely to develop CPO (OR:1.62, 95%CI:1.25–2.11), and mortality within one year (OR:1.50, 95%CI:1.17–1.92) compared to non-smokers, but SSI rates were not affected by smoking status. Current smokers had a significant increase in postsurgical length of stay (overall 4.3% [p<0.001], GI 4.7% [p=0.003], thoracic 9.0% [p<0.001]) compared to prior smokers. Prior and current smoking status is a significant risk factor for major postoperative complications and mortality following GI cancer and thoracic operations in veterans. Smoking cessation should be encouraged prior to all major cancer surgery in the VA population to decrease postoperative complications and length of stay.
登录
查看更多内容
影响因子：
4.6
作者：
Mason, David P.;Subramanian, Sreekumar;Blackstone, Eugene H.
通讯作者：
Blackstone, Eugene H.
影响因子：
3.9
作者：
Hendren, Samantha;Birkmeyer, John D.;Morris, Arden M.
通讯作者：
Morris, Arden M.
影响因子：
4.6
作者：
Wright, Cameron D.;Gaissert, Henning A.;Allen, Mark S.
通讯作者：
Allen, Mark S.
影响因子：
254.7
作者：
Fontham, Elizabeth T. H.;Thun, Michael J.;Samet, Jonathan M.
通讯作者：
Samet, Jonathan M.
影响因子：
158.5
作者：
BRENNAN, JA;BOYLE, JO;SIDRANSKY, D
通讯作者：
SIDRANSKY, D