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Smoking cessation correlates with a decrease in infection rates following total joint arthroplasty.

Christina Herrero1, Alex Tang1, Amy Wasterlain1

  • 1Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA.

Journal of Orthopaedics
|September 14, 2020
PubMed
Summary
This summary is machine-generated.

Quitting smoking before total joint arthroplasty significantly reduces infection risk. A voluntary smoking cessation program showed promising, though not statistically significant, improvements in quit rates for patients undergoing TJA.

Keywords:
ComplicationsLength of stayReadmissionsSmoking cessationTotal joint arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Public Health
  • Addiction Medicine

Background:

  • Tobacco use is a known risk factor for perioperative complications, increased hospital costs, and reduced survivorship in total joint arthroplasty (TJA).
  • Understanding the impact of smoking cessation on TJA outcomes is crucial for improving patient care.
  • Voluntary smoking cessation programs (SCP) aim to support patients in quitting tobacco use.

Purpose of the Study:

  • To evaluate the impact of tobacco cessation on patient outcomes following TJA.
  • To measure the effectiveness of a voluntary SCP in increasing smoking quit rates among TJA patients.
  • To analyze the association between smoking status and post-operative complications like infection and readmission.

Main Methods:

  • A seven-year retrospective analysis (2013-2019) of a voluntary smoking cessation program (SCP) database.
  • Evaluation of patient demographics, smoking status, length of stay (LOS), 90-day post-operative infection, and readmission rates.
  • Comparison of outcomes between patients enrolled in the SCP (intervention) and those self-treating (control).

Main Results:

  • Patients in the SCP (n=137) showed a trend towards higher quit rates (43% vs. 33%) compared to the control group (n=64).
  • A statistically significant decrease in infection rates was observed in patients who self-reported quitting tobacco pre-TJA (3.7% vs. 12.5%).
  • Trends suggested shorter LOS and slightly higher readmission rates in the SCP group, though not statistically significant.

Conclusions:

  • Self-reported tobacco cessation prior to TJA is associated with a statistically significant reduction in post-operative infection rates.
  • Voluntary smoking cessation programs demonstrate a trend towards increased pre-operative smoking cessation in TJA patients.
  • Further initiatives to promote tobacco cessation before TJA are warranted to improve patient outcomes.