Where There’s Smoke, There’s Hip and Knee Complications (written by Biloine Young @ OTW)
In one of the largest studies ever conducted to measure the effect of smoking on post operative orthopedic complications, researchers from the University of Alabama at Birmingham assessed the effects of cigarette smoking on 33,336 patients, 30 days after elective total hip or total knee replacement surgery.
No surprise, smokers who have total knee or hip replacement surgeries are at a significant risk of 30-day postoperative complications and/or death at one year. But what really hit home were these statistics:
- 53% greater chance of infection
- 161% greater chance of stroke
- 63% greater chance of 1-year mortality
- 34% greater chance of pneumonia
The study was published online July 18 by Arthritis Care & Research.
Jasvinder A. Singh, M.B.B.S., M.P.H., from the University of Alabama at Birmingham, and colleagues looked at both smokers and non-smokers. Of the 33,336 patients, 24% were current smokers, 19% were prior smokers and 57% had never smoked. The time period for the study was between 2001 and 2008. Eighty percent of the patients were Caucasian and 95 percent were male, with an average age of 64 years.
The investigators used data from the national VA Surgical Quality Improvement Program (VASQIP) to examine the association of smoking status at surgery with 30-day post-operative complication rates (including surgical site and other infections, pneumonia, stroke, myocardial infarction, mortality, and other complications) in veterans undergoing primary elective THR or TKR. The investigators employed a multilevel multivariable-adjusted logistic regression model, adjusted for age, race/ethnicity, work RVU, ASA classification and year of surgery with additional adjustment for wound classification for surgical site infections.
“Current smoking at the time of elective knee or hip replacement surgery is associated with increased post-arthroplasty complications, especially surgical site infections and pneumonia. Pre-operative smoking cessation programs should be considered in patients undergoing elective THR or TKR,” the authors wrote.