Association of preoperative smoking with the occurrence of postoperative pulmonary complications: A post hoc analysis of an observational study in 29 countries
Publikation: Beitrag in Fachzeitschrift › Forschungsartikel › Beigetragen › Begutachtung
Beitragende
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie
- Amsterdam University Medical Centers (UMC)
- Monash University
- University of Melbourne
- Austin Hospital
- Hospital Israelita Albert Einstein
- Medizinische Universität Wien
- University of Sheffield
- Massachusetts General Hospital
- Columbia University
- Universität Bonn
- University of Insubria
- BG Klinikum Bergmannstrost
- Martin-Luther-Universität Halle-Wittenberg
- Cleveland Clinic Ohio
- Mahidol Oxford Tropical Medicine Research Unit (MORU)
- University of Oxford
- Netherlands Cancer Institute
- LKH-Universitätsklinikum Graz
- Kepler Universitätsklinikum
- Université catholique de Louvain
- Vrije Universiteit Brussel
- East Limburg Hospital
- Ghent University
- Universitätsklinikum Carl Gustav Carus Dresden
Abstract
Introduction: While smoking has been consistently identified as a significant contributor to postoperative complications, the existing literature on its association with postoperative pulmonary complications remains conflicting. Aim: We examined the association of preoperative smoking with the occurrence of postoperative pulmonary complications (PPCs). Methods: Post hoc analysis of an observational study in 146 hospitals across 29 countries. We included patients at increased risk of PPCs, according to the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score (≥ 26 points). The primary endpoint was the occurrence of one or more predefined PPCs in the first five postoperative days, including unplanned postoperative need for supplementary oxygen, respiratory failure, unplanned need for invasive ventilation, ARDS, pneumonia and pneumothorax. Secondary endpoints included length of hospital stay and in–hospital mortality. We performed propensity score matching to correct for factors with a known association with postoperative outcomes. Results: Out of 2632 patients, 531 (20.2 %) patients were smokers and 2102 (79.8 %) non-smokers. At five days after surgery, 101 (19.0 %) smokers versus 404 (19.2) non–smokers had developed one or more PPCs (P = 0.95). Respiratory failure was more common in smokers (5.1 %) than non–smokers (3.0 %) (P = 0.02), while rates of other PPCs like need for supplementary oxygen, invasive ventilation, ARDS, pneumonia, or pneumothorax did not differ between the groups. Length of hospital stay and mortality was not different between groups. Propensity score matching did not change the findings. Conclusion: The occurrence of PPCs in smokers is not different from non–smokers. Funding: This analysis was performed without additional funding. LAS VEGAS was partially funded and endorsed by the European Society of Anaesthesiology through their Clinical Trial Network and the Amsterdam University Medical Centers, Amsterdam, The Netherlands. Registration: LAS VEGAS was registered at Clinicaltrials.gov (NCT01601223). Prior presentation: Preliminary study results have been presented at the Euroanaesthesia 2024 International Congress, in Munich, Germany.
Details
| Originalsprache | Englisch |
|---|---|
| Aufsatznummer | 111856 |
| Fachzeitschrift | Journal of Clinical Anesthesia |
| Jahrgang | 104 |
| Publikationsstatus | Veröffentlicht - Juni 2025 |
| Peer-Review-Status | Ja |
Externe IDs
| PubMed | 40373497 |
|---|---|
| ORCID | /0000-0002-5385-9607/work/202353852 |
| ORCID | /0000-0003-3953-3253/work/202354051 |
Schlagworte
ASJC Scopus Sachgebiete
Schlagwörter
- Anaesthesia, Intraoperative ventilation, Postoperative outcome, Postoperative pulmonary complications, PPCs, Respiratory complications, Smoking