Perioperative medicine & outcomes
Preoperative Smoking-Cessation Interventions to Prevent Postoperative Complications: A Quality Assessment and Overview of Systematic Review Evidence
Authors' conclusion
The evidence supports providing smoking-cessation interventions which include multiple behavioral support sessions and pharmacotherapy implemented at least 4 weeks before surgery to reduce postoperative complications.
Study context
- Population
- Surgical patients who smoke receiving preoperative smoking-cessation interventions6 systematic reviews · 12 primary studies
- Comparison
- Preoperative smoking-cessation interventions (by timing and components) to prevent postoperative complications
- Outcome
- Postoperative complications
Methodological detailsAMSTAR 2 quality appraisal, Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence certainty, 838 citations; 67 full-text articles screened, Searches of Cochrane Library, MEDLINE, EMBASE, CINAHL, Johanna Briggs Institute databases (inception-May 14, 2024)
- AMSTAR 2 quality appraisal
- GRADE evidence certainty
- 838 citations; 67 full-text articles screened
- Searches of Cochrane Library, MEDLINE, EMBASE, CINAHL, Johanna Briggs Institute databases (inception-May 14, 2024)
Main finding
As reported in the abstract
- Interventions started ≥4 weeks before surgery with multiple behavioral support sessions and pharmacotherapy needed to prevent postoperative complications, particularly surgical site infections (high-certainty evidence)
- Duration of smoking cessation important, benefits amplified for longer periods (high-certainty evidence)
- Interventions initiated <4 weeks before surgery (even with multiple behavioral sessions, ± pharmacotherapy), or >4 weeks before with only 1 component, increase quit rates but do not reduce complications (medium- to high-certainty evidence)
- 4 reviews including all primary studies provided moderate to high strength of evidence
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Preoperative Smoking-Cessation Interventions to Prevent Postoperative Complications: A Quality Assessment and Overview of Systematic Review Evidence. Anesth Analg. Published 9 October 2024. doi:10.
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