They analyzed data from 33,336 patients from the VA Surgical Quality Improvement Program (VASQIP) who underwent elective primary joint replacement procedures between October 2001 and September 2008. Specifically, they measured the association of smoking status at the time of surgery with 30-day, 90-day and one-year post-operative complication rates including surgical site and other infections, such as pneumonia, stroke, heart attack, and mortality.
Patients were on average 64 years old, mostly male (95 percent) and Caucasian (66 percent). Fifty-seven percent never smoked, 19 percent were prior smokers (who had stopped smoking at least a year before surgery) and 24 percent were current smokers.
"Since the risk of complications in joint replacement patients who smoke is quite significant and since it is possible that even short-term cessation may provide significant protection from such complications, it would be reasonable to approach surgical candidates for a pre-operative smoking-cessation program," said Dr. Singh. "If smokers are looking for a reason to quit, the waiting period before total joint replacement provides a golden opportunity."
Alcohol misuse a factor in likely complications (Embargo: February 15)
In the first study, researchers from Stanford University evaluated post-surgical complication rates among 185 veterans who underwent total joint replacement surgery and who had admitted consuming alcohol in the past year based on their responses to the Alcohol Use Disorders Identification Test (AUDIT-C), a standardized annual assessment conducted at VA facilities.
They found that patients who reported the highest amount of alcohol consumption (at the level considered "alcohol misuse" *) were most likely to experience complications. In fact,
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American Academy of Orthopaedic Surgeons