Evidence Supports Perioperative Nicotine Replacement Therapy

Active smokers hospitalized for a major surgical procedure who started nicotine replacement therapy (NRT) within 2 days of admission had similar outcomes as those who were not prescribed NRT, according to study results published in CHEST.

Medical records of active smokers hospitalized for a major surgical procedure were retrospectively analyzed to determine whether starting NRT perioperatively had an effect on surgical outcomes. The association of starting NRT within 2 days of admission was evaluated on the basis of the following outcomes: in-hospital complications, mortality, all-cause 30-day readmissions, and 30-day readmission for wound complications.

Among the 147,506 active smokers at 552 hospitals, 17.4% started NRT within 2 days of admission for a major surgical procedure. Individuals who started NRT were more likely to have Medicaid and a diagnosis of alcohol, substance abuse disorder, or chronic obstructive pulmonary disease compared with those who did not start NRT.

In the primary study outcomes, there was no association among receipt of NRT and in-hospital complications, mortality, all-cause 30-day readmission, or 30-day readmission for wound complications.

“[W]e found that a minority of smokers hospitalized for a surgical procedure received NRT during their hospitalization and that receipt of NRT was not associated with adverse events,” the researchers wrote.

“The findings from this study have important implications suggesting that it is safe for physicians to order NRT in the perioperative period to decrease the risk of craving and improve the hospital experience for smokers undergoing surgeries.”

Reference

Stefan MS, Pack Q, Shieh MS, et al. The association of nicotine replacement therapy with outcomes among smokers hospitalized for a major surgical procedure [published November 29, 2019]. CHEST. doi:10.1016/j.chest.2019.10.054