Andrea Truncali, MD, MPH; Scott Sherman, MD, MPH
In smokers having elective surgery, do preoperative smoking cessation interventions affect postoperative complications and smoking cessation?
Included studies compared any preoperative smoking cessation intervention (including counseling and pharmacotherapy) with placebo, usual care, or standard advice with or without nicotine replacement therapy (NRT) (control) in patients ≥ 18 years of age who smoked daily and were having elective surgery. Outcomes included postoperative complications (including wound healing and respiratory, cardiovascular, and urinary complications) and smoking cessation.
MEDLINE, EMBASE/Excerpta Medica, Cochrane Library, and CINAHL were searched for randomized controlled trials (RCTs). 11 RCTs (n = 1194) met the selection criteria and had low risk for bias on the basis of the Cochrane Collaboration’s tool. Meta-analysis was not done for smoking cessation as an outcome because of heterogeneity of studies.
Meta-analysis showed that preoperative smoking cessation interventions reduced postoperative complications within 30 days compared with control (Table). Preoperative interventions increased smoking cessation rates at 12 months in 2 RCTs but did not differ from control in 1 RCT.
Preoperative smoking cessation interventions reduce postoperative complications and increase smoking cessation in smokers having elective surgery.
Preoperative smoking interventions vs placebo, usual care, or standard advice (control) in smokers having elective surgery*
*Abbreviations defined in Glossary. Weighted event rates, RRR, NNT, and CI calculated from control event rates and risk ratios in article based on a fixed-effect model.
†Included wound healing and respiratory, cardiovascular, and urinary complications.
Truncali A, Sherman S. Review: Preoperative smoking cessation interventions reduce postoperative complications. Ann Intern Med. ;151:JC4–4. doi: 10.7326/0003-4819-151-8-200910200-02004
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Published: Ann Intern Med. 2009;151(8):JC4-4.
Cardiology, Coronary Risk Factors, Smoking, Tobacco, Alcohol, and Other Substance Abuse.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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