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Smoking As a Risk Factor for Postcraniotomy 30-Day Mortality.
Bryson C Lochte1, Kate T Carroll1, Brian Hirshman1
1Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA.
World Neurosurgery
|March 27, 2019
Summary
Heavy smoking (≥30 pack-years) increases postcraniotomy mortality risk, particularly in males undergoing neurovascular surgery. This finding highlights smoking cessation as crucial for improving surgical outcomes in this demographic.
Area of Science:
- Neurosurgery
- Public Health
- Epidemiology
Background:
- Limited data exists on smoking's impact on postcraniotomy mortality.
- The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was utilized to investigate this association.
Purpose of the Study:
- To determine the relationship between smoking history and 30-day mortality after craniotomy.
- To identify specific patient subgroups at higher risk.
Main Methods:
- Analysis of 16,280 postcraniotomy patients from the ACS-NSQIP database.
- Categorization of surgical indications: vascular, trauma, epilepsy, malignant tumor, benign tumor.
- Univariate and multivariable logistic regression to identify mortality risk factors.
Main Results:
- Overall 30-day postcraniotomy mortality was 5.03%.
- A smoking history of ≥30 pack-years was a significant risk factor for mortality (P < 0.001).
- This risk was primarily observed in males undergoing neurovascular surgery (OR 3.88).
Conclusions:
- ≥30 pack-years of smoking is a significant risk factor for mortality in male patients undergoing craniotomy for neurovascular diseases.
- Smoking cessation interventions may be critical for improving outcomes in this population.
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