Smokers live shorter and Ex-smokers live longer after major surgeries.

Jojy Cheriyan MD;MPH-June 20,2013

Life threatening post-operative complications are worse in smokers than in non-smokers or ex-smokers. A lot of research has been done on the impact of smoking on surgical outcomes.

A new study published yesterday in JAMA-Surgery ( Journal of American Medical Association-Surgery June19,2013) adds more evidence to the fact that smokers may die soon after major surgeries due to cardiovascular and respiratory complications. But, this study points out that smokers who quit smoking at least a year or more will have a reduced risk of life threatening post-surgical complications.

The objective of this study was to evaluate the association between current and past smoking on the risk of postoperative mortality as well as vascular and respiratory events in patients undergoing major surgery.

Data related to a total of 607, 558 adult patients undergoing major surgery in non–Veterans Affairs hospitals across the United States, Canada, Lebanon, and the United Arab Emirates during 2008 and 2009 were analyzed in this study.

The sample selected included 125,192 current and 78,763 past smokers. Outcomes included 30-day postoperative mortality, arterial events such as myocardial infarction (MI) or stroke, venous events such as deep vein thrombosis or pulmonary embolism, and respiratory events such as pneumonia or unplanned intubation.

Researchers found that current and past smokers had a significantly increased risk of arterial and respiratory events when compared with non-smokers, after adjusting for confounders. They also found that patients who quit smoking at least 1 year before surgery decreased their odds of mortality to 17 % from the 21% found in current smokers.

This study concludes saying "smoking cessation at least 1 year before major surgery abolishes the increased risk of postoperative mortality and decreases the risk of arterial and respiratory events evident in current smokers".

This study reiterates that benefit of smoking cessation is of paramount significance in reducing the risk of death in surgical settings.

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