Impact of preoperative intervention for smoking cessation on postoperative length of stay and cost for spine surgery patients: Propensity score matching analysis

Abstract

BackgroundPreoperative intervention for smoking cessation reduces the prevalence of postoperative complications in spine surgery. To date, however, the impact of these interventions on the length of stay (LOS) and cost for patients is unclear. Patients/methodsThis retrospective cohort study analyzed data from 317 patients who were current smokers and underwent spine surgery between January 2014 and December 2019 at a single facility in Tokyo, Japan. Most patients (262) received preoperative intervention for smoking cessation within 60 days before spine surgery; the remaining 55 patients did not receive the intervention. The postoperative LOS was compared using propensity score matching. Patients were matched for age, gender, body mass index, surgical plan (cervical surgery, anterior approach surgery, minimally invasive surgery), preoperative comorbidities (diabetes mellitus, hypertension, ischemic cardiac disease, chronic lung disease), and recent history of steroid therapy, which yielded 48 pairs of patients. ResultsThe length of postoperative hospital stay was significantly shorter in the intervention group (−10.60 days, [95% CI, −15.79 to −5.42]). The cost for service was significantly lower in the intervention group (coefficient, Japanese yen [JPY] −1,515,529; [95% CI, −2,130,631 to −900,426]; 110 JPY equivalent to 1 United States dollar). ConclusionsPreoperative interventions for smoking cessation may decrease postoperative hospital stay and hospitalization costs.