Smoking is a risk factor for incisional hernia
Smoking is a risk factor for incisional hernia
复制标题
DOI：
10.1001/archsurg.140.2.119
复制
发表时间：
2005-02-01
影响因子：
--
通讯作者：
Jorgensen, LN
中科院分区：
文献类型：
--
作者：
Sorensen, LT;Hernmingsen, UB;Jorgensen, LN
假设：已经确定了切口疝的许多危险因素，但发病机制仍不清楚。根据之前的研究结果，吸烟是伤口并发症和腹股沟疝复发的危险因素，我们研究了吸烟是否与切口疝相关。设计：队列研究。胃肠道疾病剖腹手术后 33 至 57 个月切口疝的临床随访研究。通过多元回归分析评估切口疝的预测变量。地点：丹麦哥本哈根大学 Bispebjerg 医院外科。患者：1997 年至 1998 年接受剖腹手术的所有 916 名患者。外科医生对 310 名患者进行了临床检查；排除未能参加检查、死亡或失访的患者。 主要观察指标：与患者病史、术前临床状况、手术严重程度和检查结果以及外科医生培训相关的 34 个变量。 结果：切口疝的发生率为 26%（81/310）。独立于其他危险因素和混杂因素，吸烟者发生切口疝的风险高出 4 倍（比值比 [OR]，3.93 [95% 置信区间 (Cl)，1.82-8.49]）。再次剖腹手术是与疝气相关的最强因素（OR，5.89 [95% Cl，1.78-19.48]）。其他危险因素包括术后伤口并发症 (OR, 3.91 [95% CI, 1.99-7.66])、年龄 (OR, 1.04 [95% CI, 1.021.06]) 和男性 (OR, 2.17 [95% CI, 1.21-3.91])。术后伤口并发症、年龄较大和男性。
Hypothesis: A number of risk factors for incisional hernia have been identified, but the pathogenesis remains unclear. Based on previous findings of smoking as a risk factor for wound complications and recurrence of groin hernia, we studied whether smoking is associated with incisional hernia.Design: Cohort study. Clinical follow-up study for incisional hernia 33 to 57 months following laparotomy for gastrointestinal disease. Variables predictive for incisional hernia were assessed by multiple regression analysis.Setting: Department of Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.Patients: All 916 patients undergoing laparotomy from 1997 through 1998. Surgeons performed clinical examination in 310 patients; patients who failed to meet for examination, died, or were lost to follow-up were excluded.Main Outcome Measures: Thirty-four variables related to patient history, preoperative clinical condition, operative severity and findings, and the surgeon's training.Results: The incidence of incisional hernia was 26% (81/310). Smokers had a 4-fold higher risk of incisional hernia (odds ratio [OR], 3.93 [95% confidence interval (Cl), 1.82-8.49]) independent of other risk factors and confounders. Relaparotomy was the strongest factor associated with hernia (OR, 5.89 [95% Cl, 1.78-19.48]). Other risk factors were postoperative wound complications (OR, 3.91 [95% CI, 1.99-7.66]), age (OR, 1.04 [95% CI, 1.021.06]), and male sex (OR, 2.17 [95% CI, 1.21-3.91]).Conclusion: Smoking is a significant risk factor for incisional hernia in line with relaparotomy, postoperative wound complications, older age, and male sex.