TY - JOUR
T1 - Post-Operative Complications and Readmissions Associated with Smoking Following Bariatric Surgery
AU - Yuce, Tarik K.
AU - Khorfan, Rhami
AU - Soper, Nathaniel J.
AU - Hungness, Eric S.
AU - Nagle, Alexander P.
AU - Teitelbaum, Ezra N.
AU - Bilimoria, Karl Y.
AU - Odell, David D.
N1 - Funding Information:
TKY (Agency for Healthcare Research and Quality [AHRQ] 5T32HS000078) and RK (National Institutes of Health [NIH] 5T32HL094293) were supported by a postdoctoral research fellowship. DDO receives support from the National Cancer Institute of the National Institutes of Health under Award Number K07CA216330.
Publisher Copyright:
© 2019, The Society for Surgery of the Alimentary Tract.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Background: The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. We describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent laparoscopic sleeve gastrectomy and Roux-En-Y gastric bypass from 2012 to 2017. Patient outcomes were compared based on smoking status. Primary outcomes included 30-day readmission and death or serious morbidity. Secondary outcomes included wound and respiratory complications. Multivariable logistic regression was used to determine the association between smoking status and measured outcomes. Results: Of the 133,417 patients who underwent bariatric surgery, 12,424 (9.3%) were smokers. Smokers more frequently experienced readmission (4.9% v 4.1%, p < 0.001), death or serious morbidity (3.8% v 3.4%, p = 0.019), wound complications (2% v 1.4%, p < 0.001), and respiratory complications (0.8% v 0.5%, p < 0.001). The likelihood of death or serious morbidity (OR 1.13, 95% CI 1.01–1.26), readmission (OR 1.21, 95% CI 1.10–1.33), wound (OR 1.44, 95% CI 1.24–1.68), and respiratory complications (OR 1.69, 95% CI 1.34–2.14) were greater in smokers. The adjusted ORs remained significant on subgroup analysis of laparoscopic sleeve gastrectomy and Roux-En-Y gastric bypass patients, with the exception of death or serious morbidity in laparoscopic Roux-En-Y gastric bypass (OR 1.04, 95% CI 0.89–1.24). Conclusions: Smokers undergoing bariatric surgery experience significantly worse 30-day outcomes when compared with non-smokers. There should be a continued emphasis on perioperative smoking cessation for patients being evaluated for bariatric surgery.
AB - Background: The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. We describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent laparoscopic sleeve gastrectomy and Roux-En-Y gastric bypass from 2012 to 2017. Patient outcomes were compared based on smoking status. Primary outcomes included 30-day readmission and death or serious morbidity. Secondary outcomes included wound and respiratory complications. Multivariable logistic regression was used to determine the association between smoking status and measured outcomes. Results: Of the 133,417 patients who underwent bariatric surgery, 12,424 (9.3%) were smokers. Smokers more frequently experienced readmission (4.9% v 4.1%, p < 0.001), death or serious morbidity (3.8% v 3.4%, p = 0.019), wound complications (2% v 1.4%, p < 0.001), and respiratory complications (0.8% v 0.5%, p < 0.001). The likelihood of death or serious morbidity (OR 1.13, 95% CI 1.01–1.26), readmission (OR 1.21, 95% CI 1.10–1.33), wound (OR 1.44, 95% CI 1.24–1.68), and respiratory complications (OR 1.69, 95% CI 1.34–2.14) were greater in smokers. The adjusted ORs remained significant on subgroup analysis of laparoscopic sleeve gastrectomy and Roux-En-Y gastric bypass patients, with the exception of death or serious morbidity in laparoscopic Roux-En-Y gastric bypass (OR 1.04, 95% CI 0.89–1.24). Conclusions: Smokers undergoing bariatric surgery experience significantly worse 30-day outcomes when compared with non-smokers. There should be a continued emphasis on perioperative smoking cessation for patients being evaluated for bariatric surgery.
KW - Bariatric surgery
KW - Outcomes
KW - Smoking
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U2 - 10.1007/s11605-019-04488-3
DO - 10.1007/s11605-019-04488-3
M3 - Article
C2 - 31848871
AN - SCOPUS:85076909063
SN - 1091-255X
VL - 24
SP - 525
EP - 530
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 3
ER -