BACKGROUND: The impact of tobacco use on perioperative complications, hospital costs, and survivorship in total joint arthroplasty (TJA) is well established. The aim of this study is to report the impact of tobacco cessation on outcomes after TJA and to measure the impact of a voluntary smoking cessation program (SCP) on self-reported smoking quit rates in a premier academic medical center. METHODS: A seven-year (2013-2019) SCP database was provided by the Integrative Health Promotion Department and Infection Prevention and Control Department. We evaluated program and smoking status, patient demographics, length of stay (LOS), and 90-day post-operative infection rates and readmission rates. The primary outcome was quit rates based on SCP enrollment status. The secondary outcomes measured infection rates, readmission rates, and LOS based on enrollment status and/or quit rate. RESULTS: A total of 201 eligible patients were identified: 137 patients in the SCP (intervention) group and 64 in the self-treatment (control) group. SCP patients trended towards higher quit rates (43% vs 33%, p = 0.17), shorter LOS (2.47 vs 2.62 days, p = 0.52), lower infection rates (7.3% vs 12.5%, p = 0.27) and slightly higher readmission rates (5.8% vs 4.7%, p = 0.73). In a sub-analysis, self-reported smokers demonstrated statistically significant decrease in infection (3.7% vs 12.5%, p = 0.03). CONCLUSION: There was a statistically significant decrease in infection rates in patients who self-reported quitting tobacco prior to TJA. Additionally, quit rates for patients who participated in a voluntary SCP trended towards increased pre-operative cessation. Further efforts to increase tobacco cessation prior to TJA and examine the impact on patient outcomes are needed.
BACKGROUND: The impact of tobacco use on perioperative complications, hospital costs, and survivorship in total joint arthroplasty (TJA) is well established. The aim of this study is to report the impact of tobacco cessation on outcomes after TJA and to measure the impact of a voluntary smoking cessation program (SCP) on self-reported smoking quit rates in a premier academic medical center. METHODS: A seven-year (2013-2019) SCP database was provided by the Integrative Health Promotion Department and Infection Prevention and Control Department. We evaluated program and smoking status, patient demographics, length of stay (LOS), and 90-day post-operative infection rates and readmission rates. The primary outcome was quit rates based on SCP enrollment status. The secondary outcomes measured infection rates, readmission rates, and LOS based on enrollment status and/or quit rate. RESULTS: A total of 201 eligible patients were identified: 137 patients in the SCP (intervention) group and 64 in the self-treatment (control) group. SCP patients trended towards higher quit rates (43% vs 33%, p = 0.17), shorter LOS (2.47 vs 2.62 days, p = 0.52), lower infection rates (7.3% vs 12.5%, p = 0.27) and slightly higher readmission rates (5.8% vs 4.7%, p = 0.73). In a sub-analysis, self-reported smokers demonstrated statistically significant decrease in infection (3.7% vs 12.5%, p = 0.03). CONCLUSION: There was a statistically significant decrease in infection rates in patients who self-reported quitting tobacco prior to TJA. Additionally, quit rates for patients who participated in a voluntary SCP trended towards increased pre-operative cessation. Further efforts to increase tobacco cessation prior to TJA and examine the impact on patient outcomes are needed.
Authors: Bhaveen H Kapadia; Aaron J Johnson; Qais Naziri; Michael A Mont; Ronald E Delanois; Peter M Bonutti Journal: J Arthroplasty Date: 2012-05-23 Impact factor: 4.757
Authors: Nicholas A Bedard; S Blake Dowdle; Brandon G Wilkinson; Kyle R Duchman; Yubo Gao; John J Callaghan Journal: J Arthroplasty Date: 2018-03-17 Impact factor: 4.757
Authors: David Lindström; Omid Sadr Azodi; Andreas Wladis; Hanne Tønnesen; Stefan Linder; Hans Nåsell; Sari Ponzer; Johanna Adami Journal: Ann Surg Date: 2008-11 Impact factor: 12.969
Authors: William Macaulay; James E Feng; Afshin A Anoushiravani; Jessica S Morton; William Petersen; Vivek Singh; Ran Schwarzkopf Journal: Knee Surg Relat Res Date: 2022-05-08