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Respiratory Postoperative Complications in Smokers Heighten Health Care Costs

Study results reinforce new evidence that smoking cessation plans employed preoperatively may provide potential overall healthcare cost savings.

Smokers who are undergoing elective general surgery more often experience respiratory postoperative complications that result in considerably increased hospital costs, in contrast to nonsmokers, according to research in the Journal of the American College of Surgeons.

After evaluating data on 14,853 patients, officials found that comprehensive inpatient charges were 4% higher for patients currently smoking compared with patients who had never smoked, translating to approximately $900 per patient. When the expanded complexity of the operation was figured in, hospital costs for patients currently smoking who had more complicated procedures were 6% higher measured against patients who never smoked. The same wasn’t found true for ex-smokers, for whom charges were not statistically compelling compared with patients who never smoked.

For the investigation, researchers inspected hospital costs in three areas: the operation, successive readmission within 30 days following discharge, and length of hospital admission. They estimate that roughly 30% of patients having elective general surgery procedures are current smokers.

“This research just strengthens our belief that we should encourage patients to quit smoking before their operations because of respiratory complications, in order to improve their surgical outcomes. In addition, it provides health care stakeholders and decision makers with data to make a business case for preoperative smoking cessation interventions,” said Aparna S. Kamath, MD, MS, lead study author and clinical assistant professor of internal medicine, University of Iowa Hospitals and Clinics, Iowa City. “Although our research did not directly address this issue, evidence suggests that quitting smoking before an operation, even as little as four to six weeks prior to the procedure, improves postoperative outcomes and decreases complications in patients.”