The Impact of Smoking on 30-day Morbidity and Mortality in Adult Spinal Deformity Surgery

Rafael De La Garza Ramos, Rory R. Goodwin, Mohamud Qadi, Nancy Abu-Bonsrah, Peter G. Passias, Virginie Lafage, Frank Schwab, Daniel Sciubba

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


STUDY DESIGN.: Retrospective cohort study of a prospectively-collected surgical database. OBJECTIVE.: The aim of this study was to investigate the effect of smoking on 30-day morbidity and mortality in patients undergoing surgery for adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA.: There is conflicting evidence regarding the impact of smoking on short-term outcomes after spinal fusion. METHODS.: A retrospective review of the prospectively-collected American College of Surgeons National Surgical Quality Improvement database was performed for the years 2007–2013. Patients who underwent spinal fusion for ASD were identified. 30-day morbidity and mortality were compared between current smokers and nonsmokers. The independent effect of smoking was investigated via multivariate logistic regression analysis. RESULTS.: A total of 1,368 patients met inclusion criteria and were included in this study. Of the 1,368 patients, 15.9% were smokers and 84.1% nonsmokers. The proportion of smokers who developed at least one complication was 9.7% versus 13.6% for nonsmokers (p?=?0.119). Major complication rates (including 30-day mortality) were 6.5% for smokers and 8.4% for nonsmokers (p?=?0.328). Current smoking status was not associated with increased odds of developing any complication (OR 0.90; 95% CI, 0.47–1.71; p?=?0.752) or major complications (OR 1.32; 95% CI 0.64–2.70; p?=?0.447) after multivariate analysis. CONCLUSION.: Smoking was not associated with higher 30-day complications or mortality after corrective surgery for ASD in this study. However, given the negative effects of smoking on overall health and spine surgery outcomes in the long-term, smoking cessation prior to spinal fusion is still recommended.Level of Evidence: 3

Original languageEnglish (US)
StateAccepted/In press - Jul 18 2016

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine


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