General Complications after Endoscopic Sinus Surgery in Smokers: A 2005-2016 NSQIP Analysis

Area of Science:

• Otolaryngology
• Surgical Quality Improvement
• Public Health

Background:

• Cigarette smoke exposure is linked to increased postoperative complications.
• The impact of smoking on endoscopic sinus surgery (ESS) complications remains unclear.
• A large national database study is needed due to low ESS complication rates.

Purpose of the Study:

• To investigate the association between smoking and 30-day postoperative complications after ESS.
• To compare complication rates in smokers versus nonsmokers undergoing ESS.

Main Methods:

• Analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) dataset (2005-2016).
• Identification of patients who underwent ESS.
• Comparison of 30-day postoperative complication rates, including organ/space SSI, between smokers and nonsmokers.

Main Results:

• 921 patients (182 smokers, 739 nonsmokers) were included.
• Smokers showed a higher incidence of organ/space SSI (P=.0067) and pulmonary embolism (P=.0321) on univariate analysis.
• Multivariate analysis revealed smoking was associated with increased odds of organ/space SSI (OR 4.495, P=.0347).

Conclusions:

• Cigarette smoke exposure is associated with an increased risk of organ/space surgical site infections within 30 days after ESS.
• Findings support counseling smokers considering ESS about potential infection risks.
• Further research is needed to elucidate the nature and prevention of these infections.