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 22 February 2018

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News

Smoking predicts bariatric postoperative complications

Smoking and superobesity are associated with postoperative complications, shows the most recent issue of the Journal of the American College of Surgeons.

News image

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The increase in obesity coupled with greater acceptance of the field of bariatric surgery has resulted in a substantial rise in the number of weight-loss operations.

Because obese individuals are at high risk for surgical complications, concern about the safety of bariatric procedures exists.

Earlier investigations of the clinical features associated with surgical complications have produced conflicting results.

Dr Edward Livingston and colleagues from Texas identified risk factors for surgical complications in US Veterans.

The research team analyzed data on 575 bariatric procedures performed at 12 Veterans' Affairs medical centers between 1998 and 2004.

74% of cases were men with a mean age of 51 years
Journal of the American College of Surgeons

Detailed pre-, intra-, and postoperative information and longterm mortality data were prospectively collected.

The team used the National Surgical Quality Improvement Program methodology to evaluate the data.

The researchers used multivariable logistic regression to identify clinical features associated with postoperative complications.

The team found that 74% of cases were men with a mean age of 51 years.

The researchers noted that 30-day mortality was 1%.

Overall complication rate was 1%.

Of those with complications, about 50% were of considerable clinical importance, as they were associated with prolonged length of stay.

The team observed that clinical features that were predictive of adverse events in superobesity, weight over 350 pounds, and smoking.

A more than 20 pack-year history of smoking was also associated with difficulty in weaning from a ventilator postoperatively.

Dr Livingston's team concludes, “We identified smoking and superobesity as preoperative risk factors associated with postoperative complications.”

“Future studies should examine the effect of preoperative weight loss and smoking cessation on bariatric procedure outcomes.”

J Am Coll Surg 2006: 203(5): 625-33
09 November 2006

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