Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose:
The risk of postoperative complication with tobacco use disorder and complication after total hip arthroplasty (THA) are not known. Our objective was to compare the rates of complications in current tobacco users and non-users who underwent primary THA.
Methods:
All patients who underwent primary THA at the Mayo Clinic from 2010 to 2013 were included. Current tobacco use was defined as the use of cigarettes, cigars, pipes or smokeless tobacco reported by the patients at the time of their surgery. We used Cox proportional hazards regression to assess the association of current tobacco use status with each post-THA complication, using hazard ratio (HR) and 95% confidence intervals (CI), and Kaplan-Meier survival to estimate the implant survival.
Results:
Tobacco use status was available for 3,649 patients (95%) and not available for 197 patients (5%); 3,312 (92%) were current tobacco users. Among current tobacco users, higher proportion were male (p<0.001), or were 71-80 or ≥80 years old (p=0.02 and p<0.001; reference ≤60); no differences were noted for BMI, cemented vs. uncemented implant, Charlson index or ASA class.
Compared to current tobacco non-users, the hazards were significantly higher in current tobacco users for deep infection, hazard ratio of 2.89 (95% CI: 1.26,6.64; p=0.01). Non-significant trends for higher hazards were noted for rates of any infection at 1.66 (0.78,3.49; p=0.19), and any revision, 1.66 (0.82,3.35; p=0.16). No significant differences were noted for superficial infection and periprosthetic fracture by current tobacco use.
Conclusion:
We noted that current tobacco use was associated with high risk of infection after primary THA. Future studies should determine the optimal time for tobacco use cessation before elective surgeries such as THA.
|
Endpoint |
Variable |
# events |
1 year (95% CI) |
2 years (95% CI) |
HR (95% CI) |
p-value |
|
Any revision |
Current tobacco user |
9 |
94.1 (90.2,98.1) |
94.1 (90.2,98.1) |
1.66 (0.82,3.35) |
0.16 |
|
|
Past user or never used |
61 |
97.5 (96.8,98.2) |
96.7 (95.8,97.6) |
1.0 (ref)
|
|
|
Revision for aseptic loosening |
Current tobacco user |
0 |
100 |
100 |
0.56 (0.03,10.95) |
0.70 |
|
|
Past user or never used |
10 |
99.5 (99.1,99.8) |
99.3 (98.9,99.7) |
1.0 (ref)
|
|
|
Revision for infection |
Current tobacco user |
3 |
98.4 (96.5,100) |
98.4 (96.5,100) |
1.55 (0.46,5.21) |
0.48 |
|
|
Past user or never used |
21 |
99.1 (98.7,99.5) |
99.0 (98.5,99.4) |
1.0 (ref)
|
|
|
Revision for peri-prosthetic fracture |
Current tobacco user |
1 |
99.2 (97.7,100) |
99.2 (97.7,100) |
1.79 (0.21,15.19) |
0.59 |
|
|
Past user or never used |
6 |
99.8 (99.6,100) |
99.7 (99.4,100) |
1.0 (ref)
|
|
|
Complication deep infection |
Current tobacco user |
7 |
97.1 (94.9,99.2) |
97.1 (94.9,99.2) |
2.89 (1.26,6.64) |
0.01 |
|
|
Past user or never used |
26 |
98.9 (98.5,99.4) |
98.8 (98.3,99.3) |
1.0 (ref)
|
|
|
Complication superficial infection |
Current tobacco user |
1 |
99.6 (98.7,100) |
99.6 (98.7,100) |
0.41 (0.06,3.03) |
0.38 |
|
|
Past user or never used |
25 |
98.9 (98.5,99.4) |
98.9 (98.5,99.4) |
1.0 (ref)
|
|
|
Complication any infection |
Current tobacco user |
8 |
96.6 (94.3,99.0)) |
96.6 (94.3,99.0) |
1.66 (0.78,3.49) |
0.19 |
|
|
Past user or never used |
51 |
97.9 (97.3,98.5) |
97.7 (97.1,98.4) |
1.0 (ref)
|
|
|
Complication wound complications |
Current tobacco user |
5 |
97.5 (95.3,99.8) |
97.5 (95.3,99.8) |
1.30 (0.51,3.28) |
0.59 |
|
|
Past user or never used |
40 |
98.5 (98.0,99.0) |
98.3 (97.7,98.8) |
1.0 (ref)
|
|
|
Complication peri-prosthetic fracture |
Current tobacco user |
8 |
97.5 (95.6,99.4) |
97.5 (95.6,99.4) |
0.78 (0.39,1.59) |
0.50 |
|
|
Past user or never used |
103 |
96.4 (95.7,97.1) |
96.1 (95.4,96.9) |
1.0 (ref)
|
|
To cite this abstract in AMA style:
Singh JA. Current Tobacco Use and the Rates of Complications after Total Hip Arthroplasty [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/current-tobacco-use-and-the-rates-of-complications-after-total-hip-arthroplasty/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/current-tobacco-use-and-the-rates-of-complications-after-total-hip-arthroplasty/