ArticleBMJ open2019
Effects of active smoking on postoperative outcomes in hospitalised patients undergoing elective surgery: a retrospective analysis of an administrative claims database in Japan.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Fascial Dehiscence and Incisional Hernia Prediction Models: A Systematic Review and Meta-analysis.World journal of surgery · 2022Pooled it
- Impact of preoperative smoking on outcomes of endoscopic transsphenoidal surgery for pituitary tumor.Endocrine · 2026Article
- Exploring factors that influence the implementation of presurgical smoking cessation interventions: a cross-sectional survey.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026Article
- The Survival for Pneumonectomy After Neoadjuvant Therapy in Non-small Cell Lung Cancer: A Retrospective Study from the National Cancer Center in China.Annals of surgical oncology · 2026Article
- Article
- "Smoker's paradox" in in-hospital outcomes of left ventricular assist device implantation: a population-based analysis of National Inpatient Sample from 2015-2021.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Article
- The Impact of Multidisciplinary Preoperative Optimization Program on Postoperative Outcomes Among Surgical Oncology Patients.Journal of clinical medicine · 2025Article
- Surgical outcomes of smoking and nonsmoking women with lung adenocarcinoma.Journal of thoracic disease · 2025Article
- Preoperative polycythemia may be associated with inferior postoperative outcomes: a retrospective study.Croatian medical journal · 2025Article
- Impact of nicotine product use on outcomes of patients receiving cervical disc arthroplasty: a propensity score analysis of the united States nationwide inpatient sample 2005-2020.Journal of orthopaedic surgery and research · 2025Article
- A Novel Triad of Bio-Inspired Design, Digital Fabrication, and Bio-Derived Materials for Personalised Bone Repair.Materials (Basel, Switzerland) · 2024Review
- The Influence of Patient Characteristics and Social Determinants of Health on Postoperative Complications Following Achilles Tendon Rupture.Foot & ankle international · 2024Article
- Risk factors and prognostic significance of early postoperative complications for patients who underwent pneumonectomy for lung cancer.Journal of cardiothoracic surgery · 2024Observational
- Measurement and optimization of perioperative risk among patients undergoing surgery for esophageal cancer.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2024Article
- Risk Factors Associated With Poor Outcomes After Quadriceps Tendon Repair.Orthopaedic journal of sports medicine · 2024Article
- Non-Tobacco Nicotine dependence associated with increased Postoperative Complications following Intramedullary Nailing for Intertrochanteric Femur Fractures.Journal of surgery and research · 2024Article
- Post-traumatic osteoarthritis: the worst associated injuries and differences in patients' profile when compared with primary osteoarthritis.BMC musculoskeletal disorders · 2023Article
- Smoking Cessation for Preoperative Optimization.Clinics in colon and rectal surgery · 2023Review
- The Risk of Adverse Events in Smokers Undergoing Spinal Fusion: A Systematic Review and Meta-Analysis.Global spine journal · 2023Review
- Influence of Selective Extraction/Isolation of Heme/Hemoglobin with Hydrophobic Imidazolium Ionic Liquids on the Precision and Accuracy of Cotinine ELISA Test.International journal of molecular sciences · 2022Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe purpose of this study was to investigate the effects of smoking on prognosis after elective surgeries. Incidence of 30-day postoperative complications was compared between propensity score-matched 'ever-smoker' and 'never-smoker' cohorts. Thirty-day mortality and medical costs during the hospital stay were also compared. DESIGN AND
settingA large-scale retrospective study using deidentified administrative claims data obtained from 372 acute care hospitals across Japan using the Diagnosis Procedure Combination system (ie, a flat-fee payment system).
participantsInpatients who were hospitalised to undergo elective surgery. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary endpoint of this study was incidence of 30-day postoperative complications. Secondary endpoints were 30-day mortality and total medical costs during hospitalisation. Comparison between ever-smokers and never-smokers was conducted using matched cohorts created by 1:1 propensity score matching.
resultsUsing 561 598 eligible patients, matched ever-smoker and never-smoker cohorts (n=1 55 593 each) were created. Ever-smokers were defined as patients with Brinkman Index ≥1. The percentage of patients who were male was 76.7%, and mean ages for ever-smokers and never-smokers were 65.1±13.8 years old and 66.4±15.3 years old, respectively. The Brinkman Index of the ever-smoker cohort was 677.6±553.4. Smoking was significantly associated with higher risk of 30-day postoperative complications compared with not smoking (OR 1.15, 95% CI 1.13 to 1.17, p<0.001). Similarly, smoking was significantly associated with postoperative 30-day mortality, with OR of 1.22 (95% CI 1.08 to 1.39, p=0.002).
conclusionsOur results suggest that smoking could be associated with risk of poor postoperative outcomes. In particular, a history of smoking may increase the risk of 30-day postoperative complications as well as that of 30-day mortality. The results suggest that smoking might have a harmful effect on postoperative outcomes irrespective of types of surgery.
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