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Surgical Endoscopy

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01-11-2014

The effect of smoking on bariatric surgical outcomes

Authors: Ivy N. Haskins, Richard Amdur, Khashayar Vaziri

Published in: Surgical Endoscopy | Issue 11/2014

Abstract

Background

Bariatric surgery is an effective long-term treatment for morbid obesity. Although smoking is known to increase postoperative complications, the independent effect of smoking on bariatric surgical outcomes is unclear. The purpose of this study was to investigate the effect of smoking on bariatric surgical outcomes using the National Surgical Quality Improvement Program (NSQIP).

Study design

Bariatric patients from 2005 to 2010 were identified in NSQIP for all types of bariatric procedures except adjustable gastric banding. Pre-treatment variables’ univariate associations with smoking were examined with chi-square and t tests. Association of smoking with outcomes, corrected for relevant covariates, was tested with logistic regression within laparoscopic and open treatment groups.

Results

A total of 41,445 patients underwent bariatric surgery (35,696 laparoscopic; 5,749 open). After controlling for covariates, smoking significantly increased the risk of organ space infection, prolonged intubation, reintubation, pneumonia, sepsis, shock, and longer length of stay in all patients undergoing bariatric surgery. In the open bariatric surgery subgroup, smoking was associated with a significantly higher incidence of organ space infection, prolonged intubation, pneumonia, and length of stay. In the laparoscopic surgery subgroup, smokers had a significantly increased incidence of prolonged intubation, reintubation, sepsis, shock, and length of stay. Smoking did not significantly increase the risk of mortality for patients undergoing bariatric surgery.

Conclusions

These data suggest that smoking is a modifiable preoperative risk factor that significantly increases the incidence of postoperative morbidity but not mortality in both laparoscopic and open bariatric surgery. Smoking cessation may minimize the risk of adverse outcomes. Future investigation is needed to identify the optimal length of preoperative smoking cessation.

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Title: The effect of smoking on bariatric surgical outcomes
Authors: Ivy N. Haskins
Richard Amdur
Khashayar Vaziri
Publication date: 01-11-2014
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 11/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3581-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The effect of smoking on bariatric surgical outcomes

Abstract

Background

Study design

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Study design

Results

Conclusions

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