Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively  

作　　者：Billy Insup Kim Jeffrey O'Donnell Colleen M Wixted Thorsten Markus Seyler William A Jiranek Michael Paul Bolognesi Sean Patrick Ryan 

机构地区：[1]Department of Orthopedic Surgery,Hospital for Special Surgery,New York,NY 10021,United States [2]Department of Orthopedic Surgery,New York University,New York,NY 10003,United States [3]Department of Orthopedic Surgery,Duke University Hospital,Durham,NC 27560,United States

出　　处：《World Journal of Orthopedics》2024年第7期627-634,共8页世界骨科杂志（英文版）

摘　　要：BACKGROUND Tobacco use is a well-documented modifiable risk factor for perioperative complications.AIM To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty(TJA)procedure.METHODS A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of surgery.Eligible patients were contacted via phone survey to understand their tobacco use pattern,and patient reported outcomes.A total of 37 TJA patients participated.RESULTS Our cohort was on average 61-years-old,60%(n=22)women,with an average body mass index of 30 kg/m^(2).The average follow-up time was 2.9±1.9 years.A total of 73.0%(n=27)of patients endorsed complete abstinence from tobacco use prior to surgery.Various cessation methods were used perioperatively including prescription therapy(13.5%),over the counter nicotine replacement(18.9%),cessation programs(5.4%).At final follow up,43.2%(n=16)of prior tobacco smokers reported complete abstinence.Patients who were able to maintain cessation postoperatively had improved Patient-Reported Outcomes Measurement Information System(PROMIS)-10 mental health scores(49 vs 58;P=0.01),and hip dysfunction and osteoarthritis outcome score for joint replacement(HOOS.JR)scores(63 vs 82;P=0.02).No patients in this cohort had a prosthetic joint infection or required revision surgery.CONCLUSION We report a tobacco cessation rate of 43.2%in patients undergoing elective TJA nearly 3 years postoperatively.Patients undergoing TJA who were able to remain abstinent had improved PROMIS-10 mental health scores and HOOS.JR scores.The perioperative period provides clinicians a unique opportunity to assist active tobacco smokers with cessation efforts and improve postoperative outcomes.

关 键 词：Smoking cessation Total joint arthroplasty OUTCOMES Tobacco use Postoperative abstinence 

分 类 号：R687.4[医药卫生—骨科学]