Smoking Negatively Impacts Surgical Outcome of Crohn's Disease

A new study suggests that in surgical patients with Crohn's Disease (CD), smoking drives infectious and pulmonary complications and an increased likelihood of readmission.

Researchers at Pennsylvania State University (Hershey, USA) reviewed the US National Surgical Quality Improvement Program (NSQIP) database, identifying 7,631 patients with CD that underwent surgical resection between 2005 and 2012; of these, 2,047 patients were identified as current smokers, and 5,584 identified as non- or ex-smokers. The patients were stratified based on smoking status, with surgical outcomes--such as length of stay (LOS), mortality, postoperative complications, and readmission—evaluated using regression models to assess the influence of smoking.

The results showed that smokers were more likely to have a pulmonary comorbidity, pre-operative weight loss, and a higher American Society of Anesthesiologists (ASA) classification. No differences in mortality were observed between smokers and non- or ex-smokers, and smoking status was not significantly associated with LOS. On the other hand, morbidity, and particularly infectious and pulmonary complications and readmission, were significantly associated with smoking status. The study was published on March 25, 2015, in Colorectal Disease.

Patients suffering from CD, an inflammation and ulceration process that occurs in the deep layers of the intestinal wall, experience pain in the abdomen, often in the lower right side, diarrhea, weight loss, and occasionally bleeding. Smokers with CD may experience more frequent symptom flares. How exactly smoking worsens Crohn’s symptoms remains elusive, but it is suspected that cigarette smoke damages protective mucous membranes in the digestive system, increasing the risk for inflammation.

Related Links:
Pennsylvania State University