Key result
Active cigarette smoking is linked to ~4-fold higher odds of overall postoperative complications.
Why the study?
The association between active cigarette smoking and postoperative morbidity and hospital stay after elective non-cardiac general surgery was not well characterized in a tertiary-care setting in Pakistan.
Does active cigarette smoking increase postoperative complications and hospital stay in adults undergoing elective non-cardiac general surgery?
Cohort (n=280)
No
Does active cigarette smoking increase postoperative complications and hospital stay in adults undergoing elective non-cardiac general surgery?
Odds Ratio: 3.96 (95% CI 2–7.7)
Absolute Event Rate: 37.2% vs 13%
p-value: p=<0.001
Active cigarette smoking is associated with a nearly four-fold increased risk of postoperative complications and significantly prolonged hospital stays after elective non-cardiac general surgery.
OBJECTIVES This study aimed to assess the association between active cigarette smoking and postoperative morbidity and hospital stay among adults undergoing elective non-cardiac general surgery at a tertiary-care hospital in Pakistan. METHODOLOGY This prospective observational cohort study enrolled 280 adults aged 18–60 years undergoing elective general surgical procedures at Services Institute of Medical Sciences/Services Hospital, Lahore, from November 2024 to December 2025. Participants comprised 180 active smokers and 100 non-active smokers. Smoking exposure was quantified in pack-years. Patients received standard perioperative care and were followed through 30 days after discharge. Outcomes included pulmonary complications, surgical-site or wound-related complications, postoperative fever, cardiovascular events, and total hospital stay. Associations were assessed using chi-square testing, logistic regression for overall complications, and independent-samples testing for length of stay. RESULTSOverall postoperative complications occurred in 67/180 smokers (37.2%) and 13/100 non-smokers (13.0%), corresponding to an odds ratio of 3.96 (95% CI 2.0–7.7; p<0.001). Pulmonary complications were the most frequently reported adverse event among smokers. Among smokers with more than 11 pack-years, 55/121 (45.5%) developed at least one complication. Mean total hospital stay was 14.90 days in smokers and 7.58 days in non-smokers (reported p<0.001). CONCLUSION Active smoking was associated with substantially greater postoperative morbidity and longer hospitalisation after elective general surgery. Routine preoperative tobacco assessment, pack-year documentation, and structured cessation support should be incorporated into elective surgical pathways.
No takes yet. Share an insight, caveat, or question.
Imran et al. (2026) conducted a cohort in Elective non-cardiac general surgery (n=280). Active cigarette smoking vs. Non-active smoking was evaluated on Overall postoperative complications (OR 3.96, 95% CI 2.0-7.7, p=<0.001). Active cigarette smoking was associated with nearly four times the odds of overall postoperative complications compared to non-active smoking (OR 3.96).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: