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. 2020 Mar;24(3):525-530.
doi: 10.1007/s11605-019-04488-3. Epub 2019 Dec 17.

Post-Operative Complications and Readmissions Associated with Smoking Following Bariatric Surgery

Tarik K Yuce  1   2 , Rhami Khorfan  1 , Nathaniel J Soper  2 , Eric S Hungness  2 , Alexander P Nagle  2 , Ezra N Teitelbaum  2 , Karl Y Bilimoria  1   2 , David D Odell  3   4
Affiliations

Post-Operative Complications and Readmissions Associated with Smoking Following Bariatric Surgery

Tarik K Yuce et al. J Gastrointest Surg. 2020 Mar.

Abstract

Background: The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. We describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers.

Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent laparoscopic sleeve gastrectomy and Roux-En-Y gastric bypass from 2012 to 2017. Patient outcomes were compared based on smoking status. Primary outcomes included 30-day readmission and death or serious morbidity. Secondary outcomes included wound and respiratory complications. Multivariable logistic regression was used to determine the association between smoking status and measured outcomes.

Results: Of the 133,417 patients who underwent bariatric surgery, 12,424 (9.3%) were smokers. Smokers more frequently experienced readmission (4.9% v 4.1%, p < 0.001), death or serious morbidity (3.8% v 3.4%, p = 0.019), wound complications (2% v 1.4%, p < 0.001), and respiratory complications (0.8% v 0.5%, p < 0.001). The likelihood of death or serious morbidity (OR 1.13, 95% CI 1.01-1.26), readmission (OR 1.21, 95% CI 1.10-1.33), wound (OR 1.44, 95% CI 1.24-1.68), and respiratory complications (OR 1.69, 95% CI 1.34-2.14) were greater in smokers. The adjusted ORs remained significant on subgroup analysis of laparoscopic sleeve gastrectomy and Roux-En-Y gastric bypass patients, with the exception of death or serious morbidity in laparoscopic Roux-En-Y gastric bypass (OR 1.04, 95% CI 0.89-1.24).

Conclusions: Smokers undergoing bariatric surgery experience significantly worse 30-day outcomes when compared with non-smokers. There should be a continued emphasis on perioperative smoking cessation for patients being evaluated for bariatric surgery.

Keywords: Bariatric surgery; Outcomes; Smoking.

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Conflict of interest statement

Disclosures

The authors report no conflicts of interest, financial or otherwise, related to this work.

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