Operating on Patients Who Smoke: A Survey of Thoracic Surgeons in the United States

Katy A Marino; Melissa A Little; Zoran Bursac; Jennifer L Sullivan; Robert Klesges; Benny Weksler

doi:10.1016/j.athoracsur.2016.03.076

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Operating on Patients Who Smoke: A Survey of Thoracic Surgeons in the United States

Journal article

Open access

Peer reviewed

Operating on Patients Who Smoke: A Survey of Thoracic Surgeons in the United States

Katy A Marino, Melissa A Little, Zoran Bursac, Jennifer L Sullivan, Robert Klesges and Benny Weksler

The Annals of thoracic surgery, v 102(3), pp 911-916

01 Sep 2016

DOI: https://doi.org/10.1016/j.athoracsur.2016.03.076

PMID: 27474514

Featured in Collection : UN Sustainable Development Goals @ Drexel

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Abstract

Humans

Preoperative Care

Smoking

Smoking Cessation

Surgeons

Surveys and Questionnaires

Thoracic Surgical Procedures

Although preoperative smoking is associated with increased postoperative complications in patients who undergo major thoracic surgical procedures, there are no national guidelines that address the patient's preoperative tobacco use. This study examined the typical preoperative management of thoracic surgical patients who are smokers. The link to an anonymous survey was emailed to cardiothoracic surgeons in the United States. The survey included questions regarding the likelihood of a surgeon to offer surgery and strategies used to assist patients in quitting smoking before surgery. The majority of the 158 surgeons who responded to the survey were general thoracic surgeons (68%, 107 of 158), in an academic practice (57%, 90 of 158), with more than 15 years of experience (51%, 81 of 158). An overwhelming majority of respondents (98.1%, 155 of 158) considered smoking preoperatively a risk factor for postoperative complications. The most common cessation strategy offered to smokers was pharmacologic intervention (77%, 122 of 158). Nearly half of the surgeons (47%, 74 of 156) would not perform certain operations in a patient who was a current smoker, but only 14% (10 of 74) tested patients preoperatively for smoking. Thoracic surgeons (odds ratio 2.1, p = 0.0379) and surgeons in academic practice (odds ratio 1.9, p = 0.057) were more likely to deny certain surgeries to current smokers. Two thirds of the surgeons (66%, 48 of 74) thought that the ideal wait time from smoking cessation to surgery was 2 to 4 weeks. There is significant disagreement in the cardiothoracic surgical community regarding how to treat patients who smoke, especially when deciding to deny or postpone surgery. Prospective studies and guidelines are needed.

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Details

Title: Operating on Patients Who Smoke: A Survey of Thoracic Surgeons in the United States
Creators: Katy A Marino - University of Tennessee Health Science Center
Melissa A Little - University of Tennessee Health Science Center
Zoran Bursac - University of Tennessee Health Science Center
Jennifer L Sullivan - University of Tennessee Health Science Center
Robert Klesges - University of Tennessee Health Science Center
Benny Weksler - University of Tennessee Health Science Center
Publication Details: The Annals of thoracic surgery, v 102(3), pp 911-916
Publisher: Elsevier
Resource Type: Journal article
Language: English
Academic Unit: Surgery
Web of Science ID: WOS:000382306200063
Scopus ID: 2-s2.0-84990180366
Other Identifier: 991021960795204721

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Web of Science research areas: Cardiac & Cardiovascular Systems; Respiratory System; Surgery