Smoking Raises Surgery Risks

Smokers Nearly 40% More Likely Than Nonsmokers to Die After Surgery, Study Finds

Medically Reviewed by Laura J. Martin, MD on October 19, 2010
From the WebMD Archives

Oct. 19, 2010 -- Smokers who undergo surgery are more likely than nonsmokers to have complications or to die shortly after surgical procedures, according to a new study.

The risk of death within 30 days of a wide variety of surgeries was nearly 40% higher in smokers than in nonsmokers, says Alparslan Turan, MD, associate professor of anesthesiology at the Cleveland Clinic. He presented his findings today at the 2010 annual meeting of the American Society of Anesthesiologists in San Diego.

''There was also an increase in cardiovascular complications," Turan tells WebMD. In his study comparing more than 82,000 smokers with nonsmoking patients, the smokers were:

  • 57% more likely to have cardiac arrest
  • 80% more likely to have a heart attack
  • 73% more likely to have a stroke

''The risk of pneumonia was double [for smokers]," Turan says.

The patients had a range of common surgeries, such as colon procedures, breast surgeries, appendix removal, and hysterectomy.

Smokers were also more likely to contract infections and to be put on mechanical ventilation after surgery because of complications.

The underlying trigger? "Your body chronically gets attacked by the smoke," Turan says. "Smoking increases inflammation." The inflammation increases your chances of these complications, he says.

In another study presented Monday at the meeting, researchers from Cleveland Clinic and other institutions reported that smokers also have higher levels of pain after ambulatory surgery.

Turan hopes the statistics will spur smokers to quit before surgery. The sooner the better, he tells them, but ideally at least two weeks before the procedure.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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Alparslan Turan, MD, associate professor of anesthesiology, Cleveland Clinic, Cleveland, Ohio.

Anesthesiology 2010, annual meeting of the American Society of Anesthesiologists, San Diego, Oct. 16-20, 2010.

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