Impact of preoperative intervention for smoking cessation on postoperative length of stay and cost for spine surgery patients: Propensity score matching analysis

• Published in: Anaesthesia critical care & pain medicine 2023-12, Vol.42 (6), p.101270-101270, Article 101270
• Main Authors: Ohata, Megumi, Nawa, Nobutoshi, Minami, Kotaro, Uchida, Tokujiro, Fujiwara, Takeo
• Format: Article
• Language: English
• Subjects: Cost; Length of stay; Smoking cessation intervention; Spine surgery
• ISSN: 2352-5568; 2352-5568
• DOI: 10.1016/j.accpm.2023.101270

•Preoperative intervention for smoking cessation reduces the prevalence of postoperative complications in spine surgery.•However, the impact of these interventions on the length of stay (LOS) and cost for patients was unclear.•This study showed that interventions within the 60 days of the preoperative period decreased postoperative LOS and costs in spine surgery. Preoperative intervention for smoking cessation reduces the prevalence of postoperative complications in spine surgery. To date, however, the impact of these interventions on the length of stay (LOS) and cost for patients is unclear. This retrospective cohort study analyzed data from 317 patients who were current smokers and underwent spine surgery between January 2014 and December 2019 at a single facility in Tokyo, Japan. Most patients (262) received preoperative intervention for smoking cessation within 60 days before spine surgery; the remaining 55 patients did not receive the intervention. The postoperative LOS was compared using propensity score matching. Patients were matched for age, gender, body mass index, surgical plan (cervical surgery, anterior approach surgery, minimally invasive surgery), preoperative comorbidities (diabetes mellitus, hypertension, ischemic cardiac disease, chronic lung disease), and recent history of steroid therapy, which yielded 48 pairs of patients. The length of postoperative hospital stay was significantly shorter in the intervention group (−10.60 days, [95% CI, −15.79 to −5.42]). The cost for service was significantly lower in the intervention group (coefficient, Japanese yen [JPY] −1,515,529; [95% CI, −2,130,631 to −900,426]; 110 JPY equivalent to 1 United States dollar). Preoperative interventions for smoking cessation may decrease postoperative hospital stay and hospitalization costs.