CORR Insights^®: Smoking is Associated with Increased Blood Loss and Transfusion Use After Lumbar Spinal Surgery

Excerpt

I recently performed a web search to get a sense of the scope of this topic; the search string “smoking and surgical complications” in Google [Mountain View, CA, USA] returned more than 8,100,000 sites, of which 157,000 were considered scholarly. The direct cost of chronic cigarette smoking is estimated to cost our healthcare system more than USD 170 billion dollars per year and represents the leading cause of preventable deaths [4]. Chronic cigarette smoking has been associated with a wide range of systemic disorders [1], especially (although by no means exclusively) of the pulmonary and cardiovascular systems; smoking increases the risks of peripheral vascular occlusive disease, atherosclerotic cardiovascular disease, ischemic stroke, myocardial infarction, and lung cancers [2]. Musculoskeletal effects of smoking include impaired wound and bone healing, inhibition of spinal fusion, and surgical-site infection [3]. As the current study notes, intraoperative estimated blood loss and subsequent transfusion may be an unrecognized additional problem caused by smoking cigarettes. Unquestionably, chronic cigarette smoking is a patient factor that is controllable, preventable, and depending on the longevity of the chronic cigarette smoking, partially reversible. …