Annals of vascular surgery 2017 06 21() pii S0890-5096(16)31348-6
Smoking is the single most important modifiable risk factor for patients with vascular disease. The aim of this study was to determine prevalence of smoking and cessation rates amongst patients undergoing vascular surgery in a Canadian centre.
As part of the Vascular Quality Initiative (VQI), a prospectively maintained database was used to identify the patents undergoing vascular surgery between 2010 and 2013. Smoking prevalence data was collated pre-procedure, post-procedure, and at year follow up post intervention at a median of 13 months (Mean = 14.4 ± 7.8 months). Cessation rates at 13 month follow up were assessed to determine any statistically significant univariate factors. These factors were then used to build a model through backwards logistic regression. Multicollinearity was tested by assessing both variance inflation factors (VIF) and tolerance.
Overall 624 patients had complete follow up data. Of these, 209 (33.5%) were smokers pre-surgically. At 1 year follow up of those 209 patients who were smokers pre-op, 87 (41.6%) had stopped smoking while 122 (58.4%) had not. Patients who were male and aged >70 were more likely to be smokers pre-operatively (p=0.001 and p<0.001 respectively). Cessation rates were increased in those aged >70 years (p=0.005), and in those with COPD (p=0.016). Gender was also statistically associated, with cessation rates higher in females (p=0.011).
More than one-third of patients who underwent surgery in a Canadian vascular center continue to smoke. Uniquely we report a statistically significant association between gender and post-operative cessation rates.