ArticleBJS open2023
Smoking is a predictor of complications in all types of surgery: a machine learning-based big data study.
Article in BJS open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Peri-implant femoral fractures around intramedullary nails: current management strategies and outcomes-a narrative review.Journal of orthopaedic surgery and research · 2025Pooled it
- Comorbidity Associations with Ocular Pain after Cataract Surgery: Overall and Sex-Stratified Analysis.AJO international · 2026Article
- High-Risk Substance and Polysubstance Use Among Elective Surgery Patients: Prevalence and Risk Factors.Journal of the American College of Surgeons · 2026Article
- Impact of preoperative smoking on outcomes of endoscopic transsphenoidal surgery for pituitary tumor.Endocrine · 2026Article
- Effect of smoking and smoking cessation intervention on postoperative complications of orthopedic and hand surgery: A single-center interventional study.Tobacco prevention & cessation · 2026Article
- Safety and quality outcomes of same-day discharge for gender-affirming mastectomy during the pandemic.Scientific reports · 2025Article
- The Impact of Multidisciplinary Preoperative Optimization Program on Postoperative Outcomes Among Surgical Oncology Patients.Journal of clinical medicine · 2025Article
- Prevalence, trends and outcomes from smoking in elective surgical systems: a secondary analysis of a prospective observational cohort study across 442 hospitals from 29 countries across Europe.The Lancet regional health. Europe · 2025Article
- Prospective study on smoking and postoperative complications in breast reconstruction surgery.Bioinformation · 2025Article
- Impact of the American Society of Anesthesiologists (ASA) classification on hip fracture surgery outcomes: insights from a retrospective analysis.BMC anesthesiology · 2024Article
- Early outcomes of open anterior versus posterior components separation with transversus abdominis release for large median incisional hernias: a retrospective stepwise analysis.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
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6 authors.
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Abstract
backgroundMachine learning algorithms are promising tools for smoking status classification in big patient data sets. Smoking is a risk factor for postoperative complications in major surgery. Whether this applies to all surgery is unknown. The aims of this retrospective cohort study were to develop a machine learning algorithm for clinical record-based smoking status classification and to determine whether smoking and former smoking predict complications in all surgery types.
methodsAll surgeries performed in a Finnish hospital district from 1 January 2015 to 31 December 2019 were analysed. Exclusion criteria were age below 16 years, unknown smoking status, and unknown ASA class. A machine learning algorithm was developed for smoking status classification. The primary outcome was 90-day overall postoperative complications in all surgeries. Secondary outcomes were 90-day overall complications in specialties with over 10 000 surgeries and critical complications in all surgeries.
resultsThe machine learning algorithm had precisions of 0.958 for current smokers, 0.974 for ex-smokers, and 0.95 for never-smokers. The sample included 158 638 surgeries. In adjusted logistic regression analyses, smokers had increased odds of overall complications (odds ratio 1.17; 95 per cent c.i. 1.14 to 1.20) and critical complications (odds ratio 1.21; 95 per cent c.i. 1.14 to 1.29). Corresponding odds ratios of ex-smokers were 1.09 (95 per cent c.i. 1.06 to 1.13) and 1.09 (95 per cent c.i. 1.02 to 1.17). Smokers had increased odds of overall complications in all specialties with over 10 000 surgeries. ASA class was the most important complication predictor.
conclusionMachine learning algorithms are feasible for smoking status classification in big surgical data sets. Current and former smoking predict complications in all surgery types.
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