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Editor's Choice - Prevalence of Smoking and Impact on Peri-Operative Outcomes After Elective Abdominal Aortic Aneurysm Repair.
Wong, Kitty H F; Mouton, Ronelle; Hinchliffe, Robert J.
Afiliação
  • Wong KHF; Department of Vascular Surgery, Bristol Medical School, University of Bristol, Bristol, UK; Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK. Electronic address: http://www.twitter.com/kittywonghf.
  • Mouton R; Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK; Translational Health Sciences, University of Bristol, Bristol, UK. Electronic address: http://www.twitter.com/RonelleMouton.
  • Hinchliffe RJ; Department of Vascular Surgery, Bristol Medical School, University of Bristol, Bristol, UK; Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK. Electronic address: robert.hinchliffe@bristol.ac.uk.
Eur J Vasc Endovasc Surg ; 67(6): 875-884, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38295938
ABSTRACT

OBJECTIVE:

The contemporary burden of smoking in patients undergoing elective abdominal aortic aneurysm (AAA) repair in the UK is unknown. This study aimed to quantify the prevalence of smoking in patients undergoing AAA repair in the UK and determine the association between smoking and peri-operative outcomes.

METHODS:

This was an observational cohort study. The National Vascular Registry was interrogated for adults undergoing elective infrarenal AAA repair from 2014 to 2021 for prevalence of current smokers, former smokers, and non-smokers over time. The primary outcomes were post-operative complications by smoking status. Secondary outcomes were variation in smoking rates over time and by hospital, in hospital mortality, and length of stay by smoking status. All analyses were adjusted using the validated British Aneurysm Repair score.

RESULTS:

Overall, 26 916 patients undergoing elective AAA repair were included (21.9% smokers, 62.2% former smokers, 15.9% non-smokers). The prevalence of smoking did not change over time, with a 2.4 fold variation between UK hospitals (range 13.0 - 31.8% excluding outliers). In hospital mortality was not significantly different between smokers, former smokers, and non-smokers (p > .050 for all comparisons). Compared with non-smokers, smoking was associated with increased overall (odds ratio [OR] 1.40, 95% confidence interval [CI] 1.24 - 1.57) and respiratory complications (OR 1.98, 95% CI 1.63 - 2.39), limb ischaemia (OR 1.63, 95% CI 1.19 - 2.23), bowel ischaemia (OR 1.64, 95% CI 1.06 - 2.54), return to theatre (OR 1.38, 95% CI 1.11 - 1.71), and intensive care admission (OR 1.43, 95% CI 1.31 - 1.56). Compared with former smokers, smoking was associated with increased overall (OR 1.24, 95% CI 1.14 - 1.36), respiratory (OR 1.44, 95% CI 1.27 - 1.63) and limb ischaemia complications (OR 1.48, 95% CI 1.19 - 1.84), and intensive care admission (OR 1.37, 95% CI 1.28 - 1.46). On analysis of the endovascular aneurysm repair subgroup, active smoking was associated with significantly higher rates of limb ischaemia compared with former and non-smokers (OR 2.12, 95% CI 1.49 - 3.01 and OR 1.94, 95% CI 1.19 - 3.16 respectively).

CONCLUSION:

The prevalence of smoking remains high in patients undergoing elective AAA repair with no evidence of a decline in active smokers from 2014 to 2021 compared with the general UK population. Smoking is associated with increased peri-operative complication rates.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Fumar / Mortalidade Hospitalar / Aneurisma da Aorta Abdominal / Procedimentos Cirúrgicos Eletivos Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Eur J Vasc Endovasc Surg Assunto da revista: ANGIOLOGIA Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Fumar / Mortalidade Hospitalar / Aneurisma da Aorta Abdominal / Procedimentos Cirúrgicos Eletivos Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Eur J Vasc Endovasc Surg Assunto da revista: ANGIOLOGIA Ano de publicação: 2024 Tipo de documento: Article