The Effect of Cigarette Smoking on Wound Complications After Single-Level Posterolateral and Interbody Fusion for Spondylolisthesis

Murray Echt, Rafael De la Garza Ramos, Jonathan Nakhla, Yaroslav Gelfand, Phillip Cezayirli, Ryan Holland, Merritt D. Kinon, Reza Yassari

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the impact of cigarette smoking on the development of wound complications, including wound dehiscence, superficial infection, deep infection, or organ space infection, within the first 30 postoperative days in patients undergoing surgery for spondylolisthesis. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the years 2012–2014 was used to identify adult patients who underwent single-level posterolateral fusion (PLF) or interbody fusion for spondylolisthesis. Wound complications occurring within 30 days were compared between current smokers and nonsmokers. Results: A total of 1688 patients who underwent single-level PLF or interbody fusion for spondylolisthesis were identified, among whom 271 were current smokers (16.1%). The overall wound complication rate was 3.3% for smokers versus 1.8% for nonsmokers (P = 0.095). When stratified by operative technique, the rate of wound complications was not significantly different between smokers and nonsmokers undergoing PLF (2.4% vs. 2.6%; P = 1.00); however, smokers who underwent interbody fusion were more likely to experience a wound complication compared with nonsmokers undergoing interbody fusion (3.7% vs. 1.3%; P = 0.028). On multivariate analysis, smoking was an independent predictor of organ/space infection irrespective of fusion technique used (odds ratio, 15.4; 95% confidence interval, 1.34–175.4; P = 0.028). Conclusions: The rate of wound complications was not higher in smokers undergoing PLF alone, but was significantly higher in smokers who underwent interbody fusion. However, multivariate analysis identified smoking as an independent predictor of organ/space infection irrespective of fusion technique used.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2018

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Spondylolisthesis
Smoking
Wounds and Injuries
Infection
Multivariate Analysis
Quality Improvement
Odds Ratio
Databases
Confidence Intervals

Keywords

  • ACS-NSQIP
  • Lumbar interbody fusion
  • Posterolateral fusion
  • Smoking
  • Spondylolisthesis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

The Effect of Cigarette Smoking on Wound Complications After Single-Level Posterolateral and Interbody Fusion for Spondylolisthesis. / Echt, Murray; De la Garza Ramos, Rafael; Nakhla, Jonathan; Gelfand, Yaroslav; Cezayirli, Phillip; Holland, Ryan; Kinon, Merritt D.; Yassari, Reza.

In: World Neurosurgery, 01.01.2018.

Research output: Contribution to journalArticle

Echt, Murray ; De la Garza Ramos, Rafael ; Nakhla, Jonathan ; Gelfand, Yaroslav ; Cezayirli, Phillip ; Holland, Ryan ; Kinon, Merritt D. ; Yassari, Reza. / The Effect of Cigarette Smoking on Wound Complications After Single-Level Posterolateral and Interbody Fusion for Spondylolisthesis. In: World Neurosurgery. 2018.
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title = "The Effect of Cigarette Smoking on Wound Complications After Single-Level Posterolateral and Interbody Fusion for Spondylolisthesis",
abstract = "Objective: To evaluate the impact of cigarette smoking on the development of wound complications, including wound dehiscence, superficial infection, deep infection, or organ space infection, within the first 30 postoperative days in patients undergoing surgery for spondylolisthesis. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the years 2012–2014 was used to identify adult patients who underwent single-level posterolateral fusion (PLF) or interbody fusion for spondylolisthesis. Wound complications occurring within 30 days were compared between current smokers and nonsmokers. Results: A total of 1688 patients who underwent single-level PLF or interbody fusion for spondylolisthesis were identified, among whom 271 were current smokers (16.1{\%}). The overall wound complication rate was 3.3{\%} for smokers versus 1.8{\%} for nonsmokers (P = 0.095). When stratified by operative technique, the rate of wound complications was not significantly different between smokers and nonsmokers undergoing PLF (2.4{\%} vs. 2.6{\%}; P = 1.00); however, smokers who underwent interbody fusion were more likely to experience a wound complication compared with nonsmokers undergoing interbody fusion (3.7{\%} vs. 1.3{\%}; P = 0.028). On multivariate analysis, smoking was an independent predictor of organ/space infection irrespective of fusion technique used (odds ratio, 15.4; 95{\%} confidence interval, 1.34–175.4; P = 0.028). Conclusions: The rate of wound complications was not higher in smokers undergoing PLF alone, but was significantly higher in smokers who underwent interbody fusion. However, multivariate analysis identified smoking as an independent predictor of organ/space infection irrespective of fusion technique used.",
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AU - Echt, Murray

AU - De la Garza Ramos, Rafael

AU - Nakhla, Jonathan

AU - Gelfand, Yaroslav

AU - Cezayirli, Phillip

AU - Holland, Ryan

AU - Kinon, Merritt D.

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N2 - Objective: To evaluate the impact of cigarette smoking on the development of wound complications, including wound dehiscence, superficial infection, deep infection, or organ space infection, within the first 30 postoperative days in patients undergoing surgery for spondylolisthesis. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the years 2012–2014 was used to identify adult patients who underwent single-level posterolateral fusion (PLF) or interbody fusion for spondylolisthesis. Wound complications occurring within 30 days were compared between current smokers and nonsmokers. Results: A total of 1688 patients who underwent single-level PLF or interbody fusion for spondylolisthesis were identified, among whom 271 were current smokers (16.1%). The overall wound complication rate was 3.3% for smokers versus 1.8% for nonsmokers (P = 0.095). When stratified by operative technique, the rate of wound complications was not significantly different between smokers and nonsmokers undergoing PLF (2.4% vs. 2.6%; P = 1.00); however, smokers who underwent interbody fusion were more likely to experience a wound complication compared with nonsmokers undergoing interbody fusion (3.7% vs. 1.3%; P = 0.028). On multivariate analysis, smoking was an independent predictor of organ/space infection irrespective of fusion technique used (odds ratio, 15.4; 95% confidence interval, 1.34–175.4; P = 0.028). Conclusions: The rate of wound complications was not higher in smokers undergoing PLF alone, but was significantly higher in smokers who underwent interbody fusion. However, multivariate analysis identified smoking as an independent predictor of organ/space infection irrespective of fusion technique used.

AB - Objective: To evaluate the impact of cigarette smoking on the development of wound complications, including wound dehiscence, superficial infection, deep infection, or organ space infection, within the first 30 postoperative days in patients undergoing surgery for spondylolisthesis. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the years 2012–2014 was used to identify adult patients who underwent single-level posterolateral fusion (PLF) or interbody fusion for spondylolisthesis. Wound complications occurring within 30 days were compared between current smokers and nonsmokers. Results: A total of 1688 patients who underwent single-level PLF or interbody fusion for spondylolisthesis were identified, among whom 271 were current smokers (16.1%). The overall wound complication rate was 3.3% for smokers versus 1.8% for nonsmokers (P = 0.095). When stratified by operative technique, the rate of wound complications was not significantly different between smokers and nonsmokers undergoing PLF (2.4% vs. 2.6%; P = 1.00); however, smokers who underwent interbody fusion were more likely to experience a wound complication compared with nonsmokers undergoing interbody fusion (3.7% vs. 1.3%; P = 0.028). On multivariate analysis, smoking was an independent predictor of organ/space infection irrespective of fusion technique used (odds ratio, 15.4; 95% confidence interval, 1.34–175.4; P = 0.028). Conclusions: The rate of wound complications was not higher in smokers undergoing PLF alone, but was significantly higher in smokers who underwent interbody fusion. However, multivariate analysis identified smoking as an independent predictor of organ/space infection irrespective of fusion technique used.

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KW - Smoking

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