The Effect of Smoking on 30-Day Complications Following Radical Prostatectomy

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Abstract

Micro-Abstract

To assess if smoking is associated with postoperative complications following radical prostatectomy, the National Surgical Quality Improvement Program database was analyzed. Of the 22,802 patients identified, current smokers had higher rates of pneumonia and unplanned intubation. Current smoking status as independent predictor of unplanned intubation was verified in multivariable analysis. Smoking status influences the risk of postoperative complications following prostatectomy.

Objective:

The purpose of this study was to determine if smoking status is associated with 30-day postoperative complications following radical prostatectomy.

Methods:

From the American College of Surgeons National Surgical Quality Improvement Program's (NSQIP) 2005-2013 database, we identified patients who underwent prostatectomy for treatment of prostate cancer. The cohort was stratified into current smokers, former smokers, and never smokers. Bivariable and multivariable analysis was utilized to assess the association between smoking status and risk of complications.

Results:

We identified 22,802 patients who underwent malignancy-related prostatectomy and met inclusion criteria. Based on reported smoking history, 2799 (12.3%) were current smokers, 1879 (8.2%) were former smokers, and 18,124 (79.5%) were never smokers. Current smokers had a higher rate of total complications (5.7%) in comparison with former (4.8%) and never smokers (4.6%; P = .050). Postoperative pneumonia was more frequent in current smokers (0.4%) compared with former smokers (0.2%) and never smokers (0.2%; P = .039). Unplanned intubation occurred more frequently in current smokers (0.4%) when compared with former smokers (0.3%) and never smokers (0.1%; P = .002). Multivariable analysis found that current smoking status was an independent predictor of an increased risk of unplanned intubation (odds ratio, 5.87; 95% confidence interval, 2.18-15.8; P < .001).

Conclusion:

Smoking status influences the risk of postoperative complications following prostatectomy. Specifically, current smoking status is an independent predictor of unplanned intubation within 30 days of the procedure.

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