On SAGE Insight: Why is Smoking an Independent Risk Factor of Reoperation?

Article title: Smoking Is an Independent Risk Factor of Reoperation Due to RecurrentLumbar Disc Herniation

From Global Spine Journal

This study aims to determine if age, gender, smoking status, and body mass index (BMI) are significant risk factors leading to reoperation. Multiple studies have shown that the outcomes for revision spine surgeries are inferior and have a higher rate of complications compared to primary cases. Identifying modifiable risk factors for recurrent disc herniation may help surgeons decrease the rate of reoperation and therefore improve patient outcomes. Neither age, BMI, nor gender had any statistical significant association with the risk of recurrent lumbar disc herniation (rLDH). However, smoking was associated with higher risk of reoperation due to rLDH. Smoking has been shown to accelerate disc degeneration, increase the risk of back pain, promote the development of LDH, and has a negative effect on surgical outcomes.

Abstract

Study Design:

Retrospective cohort study.

Objectives:

The purpose of the present study is to determine if age, gender, smoking status, and body mass index (BMI) are significant risk factors of symptomatic recurrent lumbar disc herniation (rLDH) leading to reoperation.

Methods:

A cohort of 1378 consecutive patients who underwent discectomy for LDH from June 2010 to January 2015 at our institution were included. Patients who underwent reoperation due to rLDH prior to August 2015 were identified. Data on reoperations, age, gender, smoking status, and BMI were collected from our database. A comparison of age, gender, smoking status, and BMI was made between the controls (non-rLDH) and the cases (rLDH group). Binary logistic regression was performed to determine whether age, gender, smoking status, and BMI were independent risk factors for rLDH.

Results:

Patients in the non-rLDH group (48.2 years) were older than the rLDH group (44.7 years; P = .013). Gender distribution (54.8% vs 48.5% males; P = .222) and BMI (26.6 vs 26.6; P = .458) were similar between the 2 groups. A significantly higher prevalence of smokers was found in the rLDH group (33.1% vs 51.5%; P < .001). Binary logistic regression analysis showed that smoking was an independent risk factor of rLDH (odds ratio = 2.12; 95% confidence interval = 1.39-3.15; P < .001).

Conclusions:

Neither age, BMI, nor gender had any statistical significant association with the risk of rLDH. Smoking was associated with higher risk of reoperation due to rLDH.

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Article details
Smoking Is an Independent Risk Factor of Reoperation Due to Recurrent Lumbar Disc Herniation
Stina Brogård Andersen, Elisabeth Corydon Smith, Christian Støttrup, Leah Y. Carreon, Mikkel O. Andersen,
First Published September 12, 2017
DOI: 10.1177/2192568217730352
From Global Spine Journal

     
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