TY - JOUR
T1 - Preoperative Cumulative Smoking Dose on Lung Cancer Surgery in a Japanese Nationwide Database
AU - Tanaka, Yugo
AU - Yamamoto, Hiroyuki
AU - Sato, Masami
AU - Toyooka, Shinichi
AU - Okada, Morihito
AU - Endo, Shunsuke
AU - Sato, Yukio
AU - Suzuki, Kenji
AU - Maniwa, Yoshimasa
AU - Fukuchi, Eriko
AU - Miyata, Hiroaki
AU - Chida, Masayuki
N1 - Funding Information:
The authors wish to thank all data managers and hospitals for participating in the NCD project and for their great efforts in entering the data. Hiroyuki Yamamoto, Eriko Fukuchi, and Hiroaki Miyata are affiliated with the Department of Healthcare Quality Assessment at the University of Tokyo. The department is a social collaboration department supported by grants from the National Clinical Database, Johnson & Johnson K.K. and Nipro Co. This work was supported by the Japan Association of Chest Surgery.
Funding Information:
The authors wish to thank all data managers and hospitals for participating in the NCD project and for their great efforts in entering the data. The authors wish to acknowledge that Hiroyuki Yamamoto, Eriko Fukuchi, and Hiroaki Miyata are affiliated with the Department of Healthcare Quality Assessment at the University of Tokyo. The department is a social collaboration department supported by grants from the National Clinical Database, Johnson & Johnson K.K., and Nipro Co. This work was supported by the Japan Association of Chest Surgery.
Publisher Copyright:
© 2022 The Society of Thoracic Surgeons
PY - 2022/1
Y1 - 2022/1
N2 - Background: Smoking is a known risk factor for postoperative mortality and morbidity. However, the significance of cumulative smoking dose in preoperative risk assessment has not been established. We examined the influence of preoperative cumulative smoking dose on surgical outcomes after lobectomy for primary lung cancer. Methods: A total of 80,989 patients with primary lung cancer undergoing lobectomy from 2014 to 2016 were enrolled. Preoperative cumulative smoking dose was categorized by pack-years (PY): nonsmokers, PY = 0; light smokers, 0 < PY < 10; moderate smokers, 10 ≤ PY < 30; and heavy smokers, 30 ≤ PY. The risk of short-term outcomes was assessed according to PY by multivariable analysis adjusted for other covariates. Results: Postoperative 30-day mortality, as well as pulmonary, cardiovascular, and infectious complications, increased with preoperative PY. Multivariable analysis revealed that the odds ratios (ORs) for postoperative mortality compared with nonsmokers were 1.76 for light smokers (P = .044), 1.60 for moderate smokers (P = .026), and 1.73 for heavy smokers (P = .003). The ORs for pulmonary complications compared with nonsmokers were 1.20 for light smokers (P = .022), 1.40 for moderate smokers (P < .001), and 1.72 for heavy smokers (P < .001). Heavy smokers had a significantly increased risk of postoperative cardiovascular (OR, 1.26; P = .002) and infectious (OR, 1.39; P = .007) complications compared with nonsmokers. Conclusions: The risk of mortality and morbidity after lung resection could be predicted according to preoperative cumulative smoking dose. These findings contribute to the development of strategies in perioperative management of lung resection patients.
AB - Background: Smoking is a known risk factor for postoperative mortality and morbidity. However, the significance of cumulative smoking dose in preoperative risk assessment has not been established. We examined the influence of preoperative cumulative smoking dose on surgical outcomes after lobectomy for primary lung cancer. Methods: A total of 80,989 patients with primary lung cancer undergoing lobectomy from 2014 to 2016 were enrolled. Preoperative cumulative smoking dose was categorized by pack-years (PY): nonsmokers, PY = 0; light smokers, 0 < PY < 10; moderate smokers, 10 ≤ PY < 30; and heavy smokers, 30 ≤ PY. The risk of short-term outcomes was assessed according to PY by multivariable analysis adjusted for other covariates. Results: Postoperative 30-day mortality, as well as pulmonary, cardiovascular, and infectious complications, increased with preoperative PY. Multivariable analysis revealed that the odds ratios (ORs) for postoperative mortality compared with nonsmokers were 1.76 for light smokers (P = .044), 1.60 for moderate smokers (P = .026), and 1.73 for heavy smokers (P = .003). The ORs for pulmonary complications compared with nonsmokers were 1.20 for light smokers (P = .022), 1.40 for moderate smokers (P < .001), and 1.72 for heavy smokers (P < .001). Heavy smokers had a significantly increased risk of postoperative cardiovascular (OR, 1.26; P = .002) and infectious (OR, 1.39; P = .007) complications compared with nonsmokers. Conclusions: The risk of mortality and morbidity after lung resection could be predicted according to preoperative cumulative smoking dose. These findings contribute to the development of strategies in perioperative management of lung resection patients.
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UR - http://www.scopus.com/inward/citedby.url?scp=85113890822&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2021.01.055
DO - 10.1016/j.athoracsur.2021.01.055
M3 - Article
C2 - 33600791
AN - SCOPUS:85113890822
SN - 0003-4975
VL - 113
SP - 237
EP - 243
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 1
ER -
