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Impact of short duration smoking cessation on post-operative complications: A systematic review and meta-analysis

2025· review· en· W4413352856 on OpenAlex
Evan Tang, Ananya Srivastava, Roshan Malhan, Isabelle Laksono, Ellene Yan, Marina Englesakis, Jean Wong, Frances Chung

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
fundA Canadian funder is recorded on the work.

Bibliographic record

VenueJournal of Clinical Anesthesia · 2025
Typereview
Languageen
FieldMedicine
TopicSmoking Behavior and Cessation
Canadian institutionsToronto Western HospitalToronto Rehabilitation InstituteUniversity of TorontoUniversity Health Network
FundersCanadian Institutes of Health ResearchUniversity of TorontoOntario Ministry of Health and Long-Term CareUniversity Health Network FoundationMerckResMed Foundation
KeywordsMedicineMeta-analysisDuration (music)Smoking cessationAnesthesiaMEDLINEInternal medicine

Abstract

fetched live from OpenAlex

BACKGROUND: Use of tobacco poses significant health risks, particularly in surgical patients, where smoking is a well-established risk factor for postoperative complications. Patients are often seen in the pre-assessment clinic 2-4 weeks prior to surgery, presenting a window of opportunity to intervene. The objective of our systematic review and meta-analysis is to explore the impact of short-term smoking cessation on postoperative outcomes, focusing on the critical 2-4-week period preceding surgery. DESIGN: Systematic review and meta-analysis. SETTING: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. PATIENTS: Adults undergoing surgical procedures with a defined smoking cessation pre-operative smoking cessation interval. MEASUREMENT: Post-operative complications including pulmonary complications, surgical site infection, wound complication, bleeding, mortality, and composite complications. RESULTS: Fifty-five studies were included in the systematic review and meta-analysis. Pulmonary complications were more prevalent in former smokers compared to non-smokers, even after cessation. Progressively longer smoking cessation periods showed improved outcomes. Compared to active smokers, preoperative cessation reduced pulmonary complications by 27 % at ≥2 weeks (RR 0.73, 95 % CI 0.60-0.89), 29 % at ≥4 weeks (RR 0.71, 95 % CI 0.61-0.82), and 37 % at ≥8 weeks (RR 0.63, 95 % CI 0.41-0.95). With ≥4 weeks of cessation, there was a 33 % lower risk of wound complications (RR 0.67, 95 % CI 0.47-0.94), 31 % lower risk of composite complications (RR 0.69, 95 %CI 0.63-0.76), and 14 % lower risk of mortality (RR 0.86, 95 % CI 0.77-0.97). Short term cessation did not seem to have a significant impact on surgical site infections or bleeding. CONCLUSIONS: Short term cessation of at least 2-4 weeks demonstrates benefits in reducing post-operative complications.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.680
Threshold uncertainty score0.758

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0040.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0110.006
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.238
GPT teacher head0.525
Teacher spread0.287 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it