Healthcare News & Insights

Smoking cessation may boost outcomes after joint replacement surgery

Smokers often have poor outcomes after procedures in hospitals. Since facilities are being judged based on patient outcomes, avoiding complications is critical. New research suggests that helping these patients quit smoking may have a positive impact on their recovery from various procedures – specifically hip and knee replacements. 

According to a news release from NYU Langone Medical Center, which conducted the study, smokers who have joint replacement surgery have a 50% increased risk of experiencing complications. In addition, recent research shows that patients who used tobacco within a month of surgery were 2.1 times more likely to develop a surgical infection than those who hadn’t done so.

And care for these patients is also an average of $5,000 more expensive than it would be for nonsmokers.

NYU Langone tackled this problem by offering patients the chance to participate in a voluntary smoking cessation program. Participants received four preoperative counseling sessions via telephone, and they were also offered nicotine replacement therapy, if needed. After the surgery, patients could participate in two postoperative follow-up counseling sessions.

The goal of the smoking cessation program was to get patients to stop using tobacco anywhere from one to two weeks before their surgery, in hopes they’d kick the habit entirely.

Initial results show promise

After the smoking cessation program’s third year, researchers reviewed medical records of 539 patients who smoked and received total joint replacement surgery at NYU Langone. Out of all these patients, 103 of them were recommended for the program by their surgeons, and 73 enrolled voluntarily. Forty-seven patients completed all six sessions.

Smokers who completed NYU Langone’s smoking cessation program were over four times more likely to quit smoking than those who didn’t enroll in the program. Almost 70% of patients who completed the program quit smoking before surgery, and 52% who enrolled in the program (but may not have completed it) also managed to kick the habit prior to their procedures.

Quitting smoking translated to better outcomes for these patients. Patients who completed the program experienced fewer complications after joint replacement surgery, including lower reoperation rates. They also experienced fewer adverse events, such as surgical site infections, readmissions, urinary tract infections, pneumonia and strokes.

To test whether these outcomes still hold up over a larger population of patients, NYU Langone researchers are currently looking at a bigger sample of smokers. However, the findings of the current study show there’s likely a correlation between getting patients to quit smoking before a procedure and a better recovery post-surgery.

That means it could be worthwhile for your hospital to offer smoking cessation to patients scheduled to receive joint replacement surgery, or even other procedures. The costs saved by avoiding potential complications would likely offset any costs of creating a program.

Plus, because Medicare has already started bundling payments for joint replacement surgery, hospitals need to do their best to curb costs by keeping patients from experiencing preventable complications, since facilities won’t be paid any extra for treating them.

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