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首页> 外文期刊>Journal of Hand Surgery. American Volume >The Impact of Smoking on Early Postoperative Complications in Hand Surgery
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The Impact of Smoking on Early Postoperative Complications in Hand Surgery

机译：吸烟对手术手术术后并发症的影响

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Purpose Smoking is a prevalent modifiable risk factor that has been associated with adverse postoperative outcomes across numerous surgical specialties. We examined the impact of smoking on 30-day complications in patients undergoing hand surgery procedures. Methods The American College of Surgeons National Surgical Quality Improvement Program data sets were queried for patients who underwent common hand surgery procedures from 2011 to 2016. Cohorts were divided into smoking and nonsmoking and compared in terms of demographic characteristics, comorbidities, and postoperative complications. Multivariable logistic regression models were used to control for demographic characteristics and comorbidities in assessing the association between smoking and postoperative infections as well as other major and minor complications. Results We identified a cohort of 48,370 patients in the National Surgical Quality Improvement Program who underwent certain outpatient and inpatient hospital facility-based hand surgery procedures from 2011 to 2016. Up to 22% of these patients reported active smoking. Compared with nonsmokers, smokers were more likely to be younger and male and to have a lower body mass index. In addition, they were more likely to have a higher American Society of Anesthesiologists classification and to report dyspnea and chronic obstructive pulmonary disease. Multivariable logistic regression identified an independent association between smoking and major complications. Smoking was not significantly associated with minor complications. When regrouped by complication type, smoking was associated with infectious and wound healing complications. In subgroup analysis, smokers undergoing elective hand surgery had increased odds of wound healing complications but not major, minor, or infectious complications. Conclusions Smokers may be at a significantly higher odds of certain complications compared with nonsmokers. For patients undergoing the elective procedures evaluated in this study, perioperative smoking may increase the risk of wound-healing complications. Copyright (C) 2021 by the American Society for Surgery of the Hand. All rights reserved.)
机译：目的吸烟是一个普遍存在的可改变的风险因素，与许多外科专科的术后不良结果有关。我们研究了手外科手术患者吸烟对30天并发症的影响。方法对2011年至2016年间接受普通手外科手术的患者的美国外科医生学会国家外科质量改进计划数据集进行查询。队列被分为吸烟组和不吸烟组，并根据人口统计学特征、共病和术后并发症进行比较。在评估吸烟与术后感染以及其他主要和次要并发症之间的关系时，使用多变量逻辑回归模型控制人口统计学特征和共病。结果我们确定了一组48370名参加国家外科质量改善计划的患者，他们在2011年至2016年期间接受了某些门诊和住院医院设施的手外科手术。高达22%的患者报告主动吸烟。与不吸烟者相比，吸烟者更年轻、更男性，体重指数更低。此外，他们更有可能有更高的美国麻醉师协会分类，并报告呼吸困难和慢性阻塞性肺疾病。多变量逻辑回归分析表明吸烟与主要并发症之间存在独立关联。吸烟与轻微并发症无显著相关性。按并发症类型重新分组时，吸烟与感染和伤口愈合并发症有关。在亚组分析中，接受选择性手外科手术的吸烟者出现伤口愈合并发症的几率增加，但没有出现严重、轻微或感染性并发症。结论与不吸烟者相比，吸烟者发生某些并发症的几率要高得多。对于接受本研究评估的选择性手术的患者，围手术期吸烟可能会增加伤口愈合并发症的风险。版权所有（C）2021美国外科学会的手。版权所有。）

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