Chest
Clinical InvestigationsSmokingRelationship Between the Duration of the Preoperative Smoke-Free Period and the Incidence of Postoperative Pulmonary Complications After Pulmonary Surgery
Section snippets
Design/Subjects
The study subjects were 288 consecutive patients who underwent a pulmonary surgical procedure at our institution between January 1997 and December 1998. By reviewing their medical records, we ascertained the preoperative and intraoperative factors, and whether PPCs occurred in each subject. The relationship between these factors and the incidence of PPCs was examined. This retrospective cohort study was approved by the Ethics Committee at Osaka Medical Center for Cancer and Cardiovascular
Characteristics of the Study Subjects in Each Group According to Smoking Habit
In the four groups, female patients comprised the majority only among the never-smokers. The age, distribution of ASA physical status, BMI, and smoking consumption of the four groups were similar (Table 1). The percentages of current smokers and ex-smokers with obstructive pulmonary disease according to the pulmonary function test result (FEV1 < 70%) were higher than the percentage in the never-smokers. The distribution of performed operations was similar among the four groups. The mean length
Discussion
This study revealed that smoking was an independent risk factor for PPCs developing in patients who underwent pulmonary surgery, and that smoking cessation prior to the surgery reduced the risk for PPC development. The moving average analysis indicated that the risk for developing a PPC started to decline in patients who stopped smoking 5 to 8 weeks prior to the surgery, and that the risk for a PPC developing in patients whose preoperative smoke-free period was > 10 weeks was similar to that in
Conclusion
Our retrospective cohort study indicated that preoperative smoking cessation reduced the risk of a PPC developing in patients who underwent pulmonary surgery, and that smoking cessation should occur at least 4 weeks prior to the surgery to lower the risk for PPCs. However, many smokers continue to smoke up to the time of surgery despite knowing the disadvantages of doing so. Thus, we urge the development of an effective cessation program for outpatients to obtain the necessary length of smoking
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Cited by (0)
This work was performed at Osaka Medical Center For Cancer and Cardiovascular Diseases.