AI Article Synopsis
- The study evaluates the impact of smoking on complications following revision total hip arthroplasty (THA), finding that current smokers have a higher risk of infections and reoperations compared to nonsmokers.
- A total of 8,237 patients were analyzed, with smokers showing rates of wound complications (4.1% vs 3.0%), deep infections (3.2% vs 1.9%), and reoperations (6.8% vs 4.8%) that were significantly higher than for nonsmokers.
- The findings suggest that smoking significantly raises the risk of adverse outcomes after revision THA, indicating a need for further research on smoking cessation to reduce these risks.
Article Abstract
Background: There is a paucity of literature evaluating the impact of smoking on revision total hip arthroplasty (THA) outcomes. The purpose of this study was to identify the effect of smoking on complications after revision THA.
Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program database to identify patients who underwent revision THA between 2006 and 2014. Patients were divided into current smokers and nonsmokers. Each cohort was compared in terms of demographics, preoperative comorbidities, and operative time. Multivariate logistic regression analysis was utilized. Adjusted odds ratios (OR) for the outcomes of any wound complication, deep infection, and reoperation within 30 days of revision THA were calculated.
Results: In total, 8237 patients had undergone a revision THA. Of these patients, 14.7% were current smokers and 85.3% were nonsmokers. Univariate analyses demonstrated that smokers had a higher rate of any wound complication (4.1% vs 3.0%, P = .04), deep infection (3.2% vs 1.9%, P = .003), and reoperation (6.8% vs 4.8%, P = .003). Multivariate analysis controlling for confounding demographic, comorbidity, and operative variables identified current smokers as having a significantly increased risk of deep infection (OR, 1.58; 95% CI, 1.04-2.38) and reoperation (OR, 1.37; 95% CI, 1.03-1.85).
Conclusion: Smoking significantly increases the risk of infection and reoperation after revision THA. The results are even more magnified for revision procedures compared to published effects of smoking on primary THA complications. Further research is needed regarding the impact of smoking cessation on mitigation of these observed risks.
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| http://dx.doi.org/10.1016/j.arth.2017.12.041 | DOI Listing |
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