Smoking status and outcomes in patients with rib fractures

Excerpt

I read with interest the recent article by Grigorian et al. [1], regarding the potential benefit of smoking, on short-term outcomes in patients with rib fractures. The results of their retrospective study confirm that despite sustaining more severe injuries and experiencing increased rates of pneumonia, both well-reported risk factors for increased mortality [2], smokers with rib fractures experienced a nearly 40% decreased risk of in-hospital mortality and one less ventilator day, than non-smokers. The ‘smokers’ paradox’ is a well-reported phenomenon in cardiovascular disease and suggested mechanisms are considered multifactorial and related to changes in oxygen delivery, endothelial function, enhanced thrombolysis and inflammation [1, 3]. Similarly, a significantly lower mortality and major complication rates in smokers with multi-trauma, compared to a comparable non-smokers multi-trauma cohort, has been reported [4]. …