New data on quitting smoking and surgical risks

New data suggests that one year after quitting smoking, your risks of a smoking-related surgical complication are the same as a non-smoker.  The study, published in JAMA Surgery, looked at over 600,000 adult patients between 2008 and 2009, and assessed the effects of current and past smoking (>1 year prior) on postoperative outcomes.

The authors tracked 30-day postoperative mortality, heart attack & stroke, DVT and pulmonary embolism, and respiratory events (pneumonia, unplanned intubation, or ventilator requirement >48 hours).Results:   If you were a “current smoker”, your odds of postoperative death were significantly increased, beginning at 10 pack-years of smoking exposure (= 1 pack a day x 10 years), and increasing from there, based on your total exposure.

Smoking cessation at least 1 year before major surgery was found to eliminate the increased risk of postoperative mortality, and also reduced the risks of perioperative heart attack, stroke, DVT and respiratory events.
Editor’s comment:  In plastic surgery, we know that smokers have a much higher risk of complication for the surgeries where large flaps of tissue are moved – like facelifts, tummy tucks and breast lifts.  The tissues can literally turn black and die…which is a bad thing.  While this study didn’t track flap necrosis as a complication, we usually recommend quitting smoking completely for at least 2 months before these kinds of surgeries.  But maybe, as this study shows, that time frame isn’t long enough – further research will have to be done to settle that question.

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