What is the Impact of Smoking on Revision Total Hip Arthroplasty?

Nicholas A Bedard; S Blake Dowdle; Jessell M Owens; Kyle R Duchman; Yubo Gao; John J Callaghan

doi:10.1016/j.arth.2017.12.041

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What is the Impact of Smoking on Revision Total Hip Arthroplasty?

Journal article

Peer reviewed

What is the Impact of Smoking on Revision Total Hip Arthroplasty?

Nicholas A Bedard, S Blake Dowdle, Jessell M Owens, Kyle R Duchman, Yubo Gao and John J Callaghan

The Journal of arthroplasty, Vol.33(7S), pp.S182-S185

07/2018

DOI: 10.1016/j.arth.2017.12.041

PMID: 29463436

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Abstract

There is a paucity of literature evaluating the impact of smoking on revision total hip arthroplasty (THA) outcomes. The purpose of this study was to identify the effect of smoking on complications after revision THA. We queried the American College of Surgeons National Surgical Quality Improvement Program database to identify patients who underwent revision THA between 2006 and 2014. Patients were divided into current smokers and nonsmokers. Each cohort was compared in terms of demographics, preoperative comorbidities, and operative time. Multivariate logistic regression analysis was utilized. Adjusted odds ratios (OR) for the outcomes of any wound complication, deep infection, and reoperation within 30 days of revision THA were calculated. In total, 8237 patients had undergone a revision THA. Of these patients, 14.7% were current smokers and 85.3% were nonsmokers. Univariate analyses demonstrated that smokers had a higher rate of any wound complication (4.1% vs 3.0%, P = .04), deep infection (3.2% vs 1.9%, P = .003), and reoperation (6.8% vs 4.8%, P = .003). Multivariate analysis controlling for confounding demographic, comorbidity, and operative variables identified current smokers as having a significantly increased risk of deep infection (OR, 1.58; 95% CI, 1.04-2.38) and reoperation (OR, 1.37; 95% CI, 1.03-1.85). Smoking significantly increases the risk of infection and reoperation after revision THA. The results are even more magnified for revision procedures compared to published effects of smoking on primary THA complications. Further research is needed regarding the impact of smoking cessation on mitigation of these observed risks.

Smoking - adverse effects

Multivariate Analysis

Comorbidity

United States

Humans

Middle Aged

Risk Factors

Postoperative Period

Male

Smoking Cessation - methods

Arthroplasty, Replacement, Hip - adverse effects

Tobacco Use Disorder

Operative Time

Quality Improvement

Reoperation - statistics & numerical data

Female

Aged

Odds Ratio

Joints

Quality of Health Care

Cohort Studies

Databases, Factual

Details

Title: Subtitle: What is the Impact of Smoking on Revision Total Hip Arthroplasty?
Creators: Nicholas A Bedard - Department of Orthopaedics, University of Iowa, Iowa City, Iowa
S Blake Dowdle - Department of Orthopaedics, University of Iowa, Iowa City, Iowa
Jessell M Owens - Department of Orthopaedics, University of Iowa, Iowa City, Iowa
Kyle R Duchman - Department of Orthopaedics, University of Iowa, Iowa City, Iowa
Yubo Gao - Department of Orthopaedics, University of Iowa, Iowa City, Iowa
John J Callaghan - Department of Orthopaedics, University of Iowa, Iowa City, Iowa
Resource Type: Journal article
Publication Details: The Journal of arthroplasty, Vol.33(7S), pp.S182-S185
Publisher: United States
DOI: 10.1016/j.arth.2017.12.041
PMID: 29463436
ISSN: 0883-5403
eISSN: 1532-8406
Language: English
Date published: 07/2018
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Internal Medicine
Record Identifier: 9984040268002771

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