Abstract
Objective:
To estimate the effect of tobacco use on several outcomes in laparoscopic hysterectomy.
Design:
Retrospective cohort study.
Patients:
69,443 patients who underwent laparoscopic hysterectomy from 2007 to 2016.
Materials and Methods:
This project utilized the American College of Surgeons' National Surgical Quality Improvement Project (NSQIP) database for 2007 and 2016 to examine patients who underwent a laparoscopic hysterectomy. Incomplete data and abdominal conversion were the only exclusion criteria. Binary logistic and linear regression were used to compare incidence of complications between cohorts. Significance was set at p = 0.05.
Results:
A total of 69,443 patients, who underwent laparoscopic hysterectomy, were included in analysis, of which 12,161 (17.5%) reported smoking within the past year. When controlling for age, body mass index, hypertension, and diabetes, the smoking cohort was found to have significantly higher incidence of deep surgical site infection (SSI) (odds ratio [OR] 1.577, 95% confidence interval [CI] 1.021–2.434, p = 0.04), organ space SSI (OR 1.336, 95% CI 1.093–1.632, p = 0.005), pneumonia (OR 2.747, 95% CI 1.711–4.410, p < 0.001), postoperative sepsis (OR 1.449, 95% CI 1.073–1.955, p = 0.015), and hospital readmission (OR 1.288, 95% CI 1.131–1.467, p < 0.001). The association between smoking and superficial SSI, intraoperative transfusion, or reoperation were not found to be statistically significant.
Conclusions:
These data demonstrate the significant association smoking has with important postoperative complications in laparoscopic hysterectomies. When controlling for other risk factors, smoking was still associated with increased risk of infection, pneumonia, and readmission. Smoking cessation is an important preoperative goal and has the potential to significantly improve surgical outcomes.
Get full access to this article
View all access options for this article.