Dangers of Smoking After Surgery

Pneumonia death rates higher among surgery patients who did not quit smoking

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) After surgery, the body needs to focus on healing. Smoking may interfere with this healing process. People who smoke after surgery could be putting their bodies at serious risk for complications.

A recent study looked at a large group of surgical patients to see if smokers had more surgery-related complications than non-smokers.

The results showed that smokers had much higher rates of death from pneumonia even up to one year after surgery compared to non-smokers.

Smokers also had higher rates of death from heart complications and infections after surgery than those who did not smoke.

"Quit smoking before surgery."

Jasvinder A. Singh, MD, MPH, associate professor of medicine at the School of Medicine at the University of Alabama at Birmingham and the Birmingham Veterans Affairs (VA) Medical Center, worked with a team of fellow healthcare providers to examine the risks for surgical complications from smoking.

“Smoking has detrimental effects on cardiovascular and lung health, and is linked to increased risk of surgical complications…including wound infection, pneumonia and mortality (death),” the authors wrote.

Previous studies have shown that quitting smoking before undergoing surgery has been associated with fewer complications after surgery.

For this study, the researchers used data from the National VA Surgical Quality Improvement Program.

The study included 322,373 patients who had one of eight different types of surgery between 2002 and 2008. The surgery types included general, vascular, orthopaedic, thoracic, otolaryngology, urology neurosurgery and plastic surgery.

One, six and 12 months after the surgery, each patient was assessed for any surgical complications, which included infections at the surgical site or wound, heart attacks, stroke and pneumonia.

A total of 186,632 patients were not smokers and 135,741 patients were current smokers. The average age of the non-smokers was 63 and the average age for smokers was 58.

The results showed that deaths six months after surgery due to infections at the surgical site were 2 percent higher among smokers compared to non-smokers.

Deaths from heart complications were 4 percent higher among smokers after six months. And deaths from pneumonia were 22 percent higher among smokers versus non-smokers six months after surgery.

One year after surgery, deaths from infections at the surgical site were still 2 percent higher among smokers compared to non-smokers.

For heart complications, deaths among smokers were 3 percent higher after one year compared to non-smokers.

Deaths from pneumonia were 16 percent higher for smokers compared to non-smokers one year after surgery.

“The first goal should always be to get smokers to quit prior to surgery,” said the authors.

In light of the high risk of pneumonia-related deaths after surgery among smokers, the authors recommended that surgical staff take special care to monitor pneumonia risk in surgical patients that continue to smoke.

This study was published in April in BMJ Open.

A Veterans Affairs research grant, the National Institute of Aging, the National Cancer Institute and Agency for Health Quality and Researcher Center for Education and Research on Therapeutics provided funding for this project. No conflicts of interest were found.

Reviewed by: 
Review Date: 
April 24, 2013
Last Updated:
August 14, 2013