Key result
Smoking was significantly associated with an increased risk of postoperative delirium compared to never-smoking in patients with pulmonary hypertension (OR 4.53).
Why the study?
Studies have reported inconsistent findings on whether smoking is a risk factor for postoperative delirium, leaving the association unverified, particularly in patients with pulmonary hypertension.
Does smoking increase the risk of postoperative delirium in surgical patients with pulmonary hypertension?
Cohort (n=539)
No
Does smoking increase the risk of postoperative delirium in surgical patients with pulmonary hypertension?
Smoking is significantly associated with an increased risk of postoperative delirium in patients with pulmonary hypertension undergoing non-cardiac surgery.
Smoking may elevate POD risk in PHTN surgical patients; leaves open whether cessation mitigates incidence in prospective trials.
BACKGROUND: Previous studies have declared that smoking was a risk factor for postoperative delirium (POD), but others have inconsistent results. Up till now, the association between smoking and POD has not been verified. This study investigates the relationship between smoking and POD in patients with pulmonary hypertension (PHTN) in the United States. METHODS: Patients with PHTN who underwent non-cardiac, non-obstetric surgery were enrolled in the original research completed by Aalap C. et al. We further excluded the patients undergoing intracranial surgery and the patients with sepsis and perioperative stroke to avoid interference with POD assessment. The generalized linear model and generalized additive model were used to explore the relationship between smoking and POD. The propensity score adjustment was used for sensitivity analyses. RESULTS: Five hundred thirty-nine patients were included in this study. The overall incidence of POD was 3.0% (16/539). After adjusting the potential confounders (age, systemic hypertension, coronary artery disease, COPD, length of surgery, intrathoracic surgery, vascular surgery), a positive relationship was found between smoking status and POD (OR = 4.53, 95% CI: 1.22 to 16.86, P = 0.0243). In addition, the curvilinear relationship between smoking burden (pack-years) and POD is close to a linear relationship. CONCLUSION: Smoking probably shows a positive correlation with POD in patients with PHTN.
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Zhou et al. (2022) conducted a cohort in Pulmonary hypertension undergoing non-cardiac, non-obstetric surgery (n=539). Smoking vs. Never-smokers was evaluated on Postoperative delirium (POD) (OR 4.53, 95% CI 1.22 to 16.86, p=0.0243). Smoking was significantly associated with an increased risk of postoperative delirium compared to never-smoking in patients with pulmonary hypertension (OR 4.53).
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