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Smoking and joint replacement: resource consumption and short-term outcome
C J Lavernia1, R J Sierra, O Gomez-Marin
1Department of Orthopaedics, University of Miami, School of Medicine, FL, USA.
Clinical Orthopaedics and Related Research
|November 5, 1999
Summary
Smoking increases surgical complications and costs. Preoperative smoking cessation is crucial for better outcomes and reduced healthcare expenses in joint replacement patients.
Area of Science:
- Orthopaedic Surgery
- Public Health
Background:
- Smoking is a known risk factor for increased morbidity and mortality in surgical procedures.
- Previous studies highlight smoking's negative impact on skin flap healing, nonunion treatment, and spinal fusion rates.
Purpose of the Study:
- To evaluate the effects of smoking on short-term complications, resource utilization, and hospital stay duration in hip and knee arthroplasty patients.
Main Methods:
- A cohort of 202 patients undergoing hip and knee arthroplasty was assessed.
- Smoking history was collected, and pack-years were calculated.
- Short-term outcomes included hospital charges, length of stay, and complication incidence.
Main Results:
- Smokers, despite being younger with fewer comorbidities, experienced longer operative and anesthesia times.
- Patients who smoked incurred statistically higher hospital charges compared to non-smokers.
- Previous smokers demonstrated better short-term outcomes than current smokers.
Conclusions:
- Smoking is associated with increased operative complexity, longer hospital stays, and higher healthcare costs in arthroplasty patients.
- Preoperative screening for smoking status can help predict resource consumption.
- Smoking abstinence prior to joint replacement surgery is strongly recommended for improved patient outcomes.