A preoperative smoking intervention decreased postoperative complications in elective knee or hip replacement
QUESTION: Does a preoperative smoking intervention reduce postoperative morbidity and mortality in patients having elective knee or hip replacement?
Design
Randomised {allocation concealed}*, blinded (outcome assessor), controlled trial with follow up to discharge.
Setting
3 university affiliated hospitals in Copenhagen, Denmark.
Patients
120 patients who were scheduled for primary elective hip or knee replacement and were daily smokers. Patients with a weekly alcohol intake >35 units were excluded. 108 patients (90%) were included in the analysis (median age 65 y, 57% women).
Intervention
At 6–8 weeks before surgery, 60 patients were allocated to the smoking intervention and were offered a weekly meeting with the project nurse. At the first meeting, a Fagerstöm test was done to estimate the patient's nicotine dependence. Test results and patient preference were used to devise a personalised nicotine substitution schedule. Patients were strongly encouraged to stop smoking, …
