TABLE 2.
30-Day Risk-adjusted Postoperative Complication Rates by Smoking Status
| Never Smoker | Former Smoker | Recent Smoker | ||||
|---|---|---|---|---|---|---|
|
| ||||||
| Rate, % | OR | Rate, % | OR | Rate, % | OR | |
| Roux-en-Y Gastric Bypass | ||||||
| Any Complication | 11.50 | Ref | 10.54 | 0.92* (0.84–1.00) | 14.34 | 1.11 (0.94–1.31) |
| Severe Complication | 2.89 | Ref | 3.70 | 1.08 (0.93–1.25) | 5.38 | 1.34* (1.01–1.77) |
| Medical Complication | 1.79 | Ref | 1.85 | 0.95 (0.78–1.16) | 2.31 | 1.10 (0.74–1.64) |
| Cardiac | 0.20 | Ref | 0.16 | 0.78 (0.41–1.47) | 0.00 | N/A (N/A) |
| Respiratory | 1.30 | Ref | 1.38 | 0.96 (0.76–1.21) | 1.59 | 1.05 (0.66–1.66) |
| Renal | 0.11 | Ref | 0.16 | 1.07 (0.51–2.21) | 0.18 | 1.32 (0.30–5.83) |
| Venous Thromboembolism | 0.39 | Ref | 0.52 | 1.11 (0.95–1.30) | 0.87 | 1.45 (0.72–2.94) |
| Surgical Complication | 8.33 | Ref | 8.22 | 0.96 (0.87–1.06) | 10.40 | 1.10 (0.91–1.34) |
| Hemorrhage | 2.53 | Ref | 3.41 | 1.11 (0.95–1.30) | 3.27 | 1.15 (0.83–1.59) |
| Leak or perforation | 0.62 | Ref | 0.79 | 1.12 (0.82–1.53) | 1.21 | 1.39 (0.78–2.49) |
| Anastomotic Leak | 0.46 | Ref | 0.50 | 0.98 (0.67–1.42) | 0.91 | 1.44 (0.71–2.90) |
| Wound Complication | 3.18 | Ref | 3.10 | 0.94 (0.81–1.10) | 4.97 | 1.25 (0.94–1.66) |
| Obstruction | 2.72 | Ref | 2.02 | 0.85 (0.72–1.02) | 1.38 | 0.68 (0.46–1.02) |
| Small Bowel Obstruction | 0.74 | Ref | 0.94 | 1.09 (0.82–1.47) | 0.73 | 0.95 (0.51–1.79) |
|
| ||||||
| Sleeve Gastrectomy | ||||||
| Any Complication | 5.25 | Ref | 6.09 | 1.03 (0.91–1.16) | 5.93 | 1.04 (0.86–1.25) |
| Severe Complication | 1.64 | Ref | 1.67 | 0.96 (0.77–1.19) | 2.38 | 1.18 (0.87–1.62) |
| Medical Complication | 1.07 | Ref | 0.87 | 0.84 (0.63–1.11) | 0.89 | 0.89 (0.57–1.39) |
| Cardiac | 0.07 | Ref | 0.12 | 1.21 (0.48–3.05) | 0.09 | 1.20 (0.26–5.44) |
| Respiratory | 0.61 | Ref | 0.48 | 0.79 (0.54–1.15) | 0.57 | 0.91 (0.51–1.62) |
| Renal | 0.06 | Ref | 0.08 | 0.98 (0.35–2.81) | 0.11 | 1.34 (0.28–6.41) |
| Venous Thromboembolism | 0.47 | Ref | 0.38 | 0.88 (0.57–1.36) | 0.32 | 0.84 (0.42–1.68) |
| Surgical Complication | 2.71 | Ref | 3.38 | 1.06 (0.90–1.25) | 3.67 | 1.14 (0.89–1.45) |
| Hemorrhage | 1.13 | Ref | 1.51 | 1.02 (0.80–1.30) | 1.62 | 1.20 (0.83–1.75) |
| Leak or perforation | 0.33 | Ref | 0.48 | 1.21 (0.79–1.86) | 0.89 | 1.65 (0.93–2.92) |
| Anastomotic Leak | 0.01 | Ref | 0.07 | 2.98 (0.48–18.53) | 0.00 | N/A (N/A) |
| Wound Complication | 0.79 | Ref | 1.02 | 1.10 (0.82–1.48) | 1.08 | 1.16 (0.75–1.81) |
| Obstruction | 0.54 | Ref | 0.41 | 0.84 (0.56–1.27) | 0.28 | 0.71 (0.35–1.41) |
| Small Bowel Obstruction | 0.10 | Ref | 0.03 | 0.53 (0.17–1.63) | 0.31 | 1.77 (0.57–5.47) |
p < 0.05 compared with risk-adjusted complication rate of never smoker.
Variables included in risk-adjustment model: procedure type (RYGB or Sleeve Gastrectomy), surgical approach (open, laparoscopic, or robot-assisted), gender, age at procedure, BMI at program start, insurance payer, cardiovascular disease (hypertension, peripheral vascular disease, or other cardiovascular disease), diabetes (type 1, type 2, insulin-dependent, or other), lung disease (serious disease or asthma), liver disease (nonalcoholic fatty liver disease or other), musculoskeletal disorder, psychological disorder (depression, anxiety, bipolar, or other), peptic ulcer disease, kidney failure, sleep apnea, urinary incontinence, venous thromboembolism, and total number of comorbidities.