[Vascular surgery and smoking--a retrospective multivariant analysis]

Abstract

In a retrospective study of 2,988 patients operated because of chronic occlusive arterial disease preoperative smoking habits were related to the patency rates of arterial reconstructions of carotid arteries, infrarenal aorta, iliac vessels, of the lower extremity, and to overall survival rates: 1) 75.2% of the patients were smokers, 24.8% were nonsmokers (NS). 2) Smokers needed the first vascular procedure about 7 years earlier than NS (62.4 +/- 10.3 vs. 69.9 +/- 9.9 years of age; p = 0.001). 3) A significant difference between the 2 groups could be found regarding the location of occlusion (p = 0.000): 20.7% of all occlusions of infrarenal aorta and iliac vessels occurred in smokers (8.8% NS), whereas NS showed a higher percentage of carotid artery stenosis (20.5 vs. 11.9% in smokers). 4) Postoperative morbidity and mortality did not differ between the 2 groups. There was no difference regarding primary patency rates and preoperative smoking habits. 5) The late patency rates of reconstruction of the legs were 72.4 and 52.9% for smokers 1 and 5 years after operation, which was significantly higher than in NS (65.5 and 46%). 6) The overall number of reoperations was higher in smokers than in NS (p = 0.001). 7) Smokers received significantly less often a further anticoagulant treatment than NS (40 vs. 47%; p < or = 0.05). 8) Preoperative smoking habits influenced the overall survival rate in a statistically significant manner with disadvantage for smokers (74.5 vs. 79.9 years; p = 0.000).