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Smokers with Crohn's face worse surgical outcomes: A 90-day perioperative analysis
Daniel Shaham1, Shira Naveh2, Meir Zemel2
1IBD Unit, Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Objective:
Smoking is associated with increased severity and recurrence of Crohn's disease (CD), but its impact on perioperative outcomes is unclear. This study evaluated the association between smoking and 90-day postoperative complications in patients with CD undergoing abdominal surgery.
Methods:
We conducted a retrospective cohort study (2017-2019) of 294 patients with CD who underwent abdominal surgery. Patients were categorized as current smokers versus past/never smokers. Outcomes included 90-day complications, severe complications (Clavien-Dindo ≥3), and length of stay (LOS). Multivariable regression was performed to adjust for confounders.
Results:
Current smokers (n = 79, 26.8 %) had higher rates of overall (64.6 % vs. 43.7 %, p = 0.002) and severe complications (19 % vs. 6.5 %, p = 0.001). Smoking was independently associated with overall complications (OR = 2.17), severe complications (OR = 3.20), and prolonged LOS (β = 3.01 days, p = 0.002). Past smokers had outcomes similar to never smokers.
Conclusion:
Current smoking is independently associated with increased complications and longer hospitalization following CD surgery.
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