The association between smoking status and post-operative complications in pelvic organ prolapse corrective surgeries.
Pelvic organ prolapse
Postoperative complications
Smoking
Tobacco
Journal
International urogynecology journal
ISSN: 1433-3023
Titre abrégé: Int Urogynecol J
Pays: England
ID NLM: 101567041
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
01
04
2022
accepted:
24
05
2022
pubmed:
9
6
2022
medline:
25
2
2023
entrez:
8
6
2022
Statut:
ppublish
Résumé
Tobacco is a known risk factor for pelvic organ prolapse (POP) as well as postoperative complications in general surgery procedures. Very little is known regarding the impact of tobacco use on postoperative outcomes in POP-correcting procedures, however. We hypothesize that tobacco use will be associated with an increased risk of postoperative complications in these procedures. This study utilized the National Surgical Quality Improvement Program (NSQIP) database for the years 2012-2020. Patients who underwent POP-correcting procedures were identified using current procedural terminology (CPT) codes. Baseline characteristics between the patient populations were compared using chi-square and one-way ANOVA tests as indicated. Binary logistic regression was used to evaluate the incidence of postoperative complications based on smoking status while controlling for demographic and clinical factors. This study included 43,406 total patients, 39,614 non-smokers and 3792 smokers. Postoperative complications including deep wound infections (P < 0.001), intraperitoneal infections (P = 0.003), wound dehiscence (P = 0.014), urinary tract infections (P = 0.029), and hospital readmissions (P < 0.001) were significantly higher in patients who smoke than those who do not. Further evaluation of patients who did not undergo mesh placement intraoperatively and those who solely underwent vaginal procedures showed similar trends. This study demonstrates a higher incidence of postoperative complications after POP-correcting procedures in patients with who smoke. Wound complications, urinary tract infections, and hospital readmission confer a considerable amount of risk to patient outcomes in addition to significant healthcare cost. Consideration should be given to smoking status in preoperative evaluation and counseling before these procedures.
Identifiants
pubmed: 35674812
doi: 10.1007/s00192-022-05255-w
pii: 10.1007/s00192-022-05255-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
751-757Informations de copyright
© 2022. The International Urogynecological Association.
Références
Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database System Rev. 2013;4:CD004014.
Price N, Slack A, Jwarah E, Jackson S. The incidence of reoperation for surgically treated pelvic organ prolapse: an 11-year experience. Menopause Int. 2008;14(4):145–8.
doi: 10.1258/mi.2008.008029
Dallenbach P, Jungo Nancoz C, Eperon I, Dubuisson JB, Boulvain M. Incidence and risk factors for reoperation of surgically treated pelvic organ prolapse. Int Urogynecol J. 2012;23(1):35–41.
doi: 10.1007/s00192-011-1483-3
Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24(11):1783–90.
doi: 10.1007/s00192-013-2169-9
Wieslander CK, Word RA, Schaffer JI, McIntire DD, Woodman P, O'Boyle A, et al. Paper 34: Smoking is a risk factor for pelvic organ prolapse. Female Pelvic Med Reconstruct Surg. 2005;11:S16–S7.
doi: 10.1097/01.spv.0000176109.39830.72
Alnaif B, Drutz HP. The association of smoking with vaginal flora, urinary tract infection, pelvic floor prolapse, and post-void residual volumes. J Low Genit Tract Dis. 2001;5(1):7–11.
Schulten SF, Detollenaere RJ, Inthout J, Kluivers KB, Van Eijndhoven HW. Risk factors for pelvic organ prolapse recurrence after sacrospinous hysteropexy or vaginal hysterectomy with uterosacral ligament suspension. Am J Obstet Gynecol. 2022.
McDaniel JC, Browning KK. Smoking, chronic wound healing, and implications for evidence-based practice. J Wound Ostomy Continence Nurs. 2014;41(5):415–23 quiz E1-2.
doi: 10.1097/WON.0000000000000057
Sorensen LT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg. 2012;255(6):1069–79.
doi: 10.1097/SLA.0b013e31824f632d
Kean J. The effects of smoking on the wound healing process. J Wound Care. 2010;19(1):5–8.
doi: 10.12968/jowc.2010.19.1.46092
Wong LS, Martins-Green M. Firsthand cigarette smoke alters fibroblast migration and survival: implications for impaired healing. Wound Repair Regen. 2004;12(4):471–84.
doi: 10.1111/j.1067-1927.2004.12403.x
Lowman JK, Woodman PJ, Nosti PA, Bump RC, Terry CL, Hale DS. Tobacco use is a risk factor for mesh erosion after abdominal sacral colpoperineopexy. Am J Obstet Gynecol. 2008;198(5):561 e1–4.
doi: 10.1016/j.ajog.2008.01.048
Deng T, Liao B, Luo D, Shen H, Wang K. Risk factors for mesh erosion after female pelvic floor reconstructive surgery: a systematic review and meta-analysis. BJU Int. 2016;117(2):323–43.
doi: 10.1111/bju.13158
Cundiff GW, Varner E, Visco AG, Zyczynski HM, Nager CW, Norton PA, et al. Risk factors for mesh/suture erosion following sacral colpopexy. Am J Obstet Gynecol. 2008;199(6):688 e1–5.
doi: 10.1016/j.ajog.2008.07.029
Araco F, Gravante G, Sorge R, Overton J, De Vita D, Primicerio M, et al. The influence of BMI, smoking, and age on vaginal erosions after synthetic mesh repair of pelvic organ prolapses. A multicenter study. Acta Obstet Gynecol Scand. 2009;88(7):772–80.
doi: 10.1080/00016340903002840
Gronkjaer M, Eliasen M, Skov-Ettrup LS, Tolstrup JS, Christiansen AH, Mikkelsen SS, et al. Preoperative smoking status and postoperative complications: a systematic review and meta-analysis. Ann Surg. 2014;259(1):52–71.
doi: 10.1097/SLA.0b013e3182911913
Theadom A, Cropley M. Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review. Tob Control. 2006;15(5):352–8.
doi: 10.1136/tc.2005.015263
Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144–54 e8.
doi: 10.1016/j.amjmed.2010.09.013
DeLancey JO, Blay E Jr, Hewitt DB, Engelhardt K, Bilimoria KY, Holl JL, et al. The effect of smoking on 30-day outcomes in elective hernia repair. Am J Surg. 2018;216(3):471–4.
doi: 10.1016/j.amjsurg.2018.03.004
Landin M, Kubasiak JC, Schimpke S, Poirier J, Myers JA, Millikan KW, et al. The effect of tobacco use on outcomes of laparoscopic and open inguinal hernia repairs: a review of the NSQIP dataset. Surg Endosc. 2017;31(2):917–21.
doi: 10.1007/s00464-016-5055-y
Sorensen LT. Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Arch Surg. 2012;147(4):373–83.
doi: 10.1001/archsurg.2012.5
Delgado-Rodriguez M, Medina-Cuadros M, Martinez-Gallego G, Gomez-Ortega A, Mariscal-Ortiz M, Palma-Perez S, et al. A prospective study of tobacco smoking as a predictor of complications in general surgery. Infect Control Hosp Epidemiol. 2003;24(1):37–43.
doi: 10.1086/502113
Coon D, Tuffaha S, Christensen J, Bonawitz SC. Plastic surgery and smoking: a prospective analysis of incidence, compliance, and complications. Plast Reconstr Surg. 2013;131(2):385–91.
doi: 10.1097/PRS.0b013e318277886a
Kawachi I, Colditz GA, Stampfer MJ, Willett WC, Manson JE, Rosner B, et al. Smoking cessation and time course of decreased risks of coronary heart disease in middle-aged women. Arch Intern Med. 1994;154(2):169–75.
doi: 10.1001/archinte.1994.00420020075009
Lee DH, Ha MH, Kim JR, Jacobs DR Jr. Effects of smoking cessation on changes in blood pressure and incidence of hypertension: a 4-year follow-up study. Hypertension. 2001;37(2):194–8.
doi: 10.1161/01.HYP.37.2.194
van der Meer RM, Wagena EJ, Ostelo RW, Jacobs JE, van Schayck CP. Smoking cessation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2003;2:CD002999.