Reduced Impact of Smoking Status on 30-Day Complication and Readmission Rates After Elective Spinal Fusion (≥3 Levels) for Adult Spine Deformity: A Single Institutional Study of 839 Patients

Aladine A. Elsamadicy, Owoicho Adogwa, Amanda Sergesketter, Victoria D. Vuong, Emily Lydon, Shay Behrens, Joseph Cheng, Carlos A. Bagley, Isaac O. Karikari

Research output: Contribution to journalArticle

8 Scopus citations


Background Smoking status has been shown to affect postoperative outcomes after surgery. The aim of this study was to determine whether patients’ smoking status impacts 30-day complication and readmission rates after elective complex spinal fusion (≥3 levels). Methods The medical records of 839 adult spinal deformity patients undergoing elective complex spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 124 (14.8%) smokers and 715 (85.2%) nonsmokers. Patient demographics, comorbidities, intraoperative and postoperative complications, and 30-day readmission rates were collected for each patient. The primary outcome investigated in this study was the rate of 30-day postoperative complication and readmission rates. Results Patient demographics and comorbidities were similar between both groups, including age, sex, and body mass index. Median [interquartile] number of fusion levels and operative time were similar between the cohorts (smoker: 5 [4–7] vs. nonsmoker: 5 [4–8], P = 0.58) and (smoker: 309.6 ± 157.9 minutes vs. nonsmoker: 287.5 ± 131.7 minutes, P = 0.16), respectively. Both cohorts had similar postoperative complication rates and lengths of hospital stay. There was no significant difference in 30-day readmission between the cohorts (smoker: 12.9% vs. nonsmoker: 10.8%, P = 0.48). There were no observed differences in 30-day complication rates, including pain (P = 0.46), UTI (P = 0.54), hardware failure (P = 0.36), wound dehiscence (P = 0.29), and wound drainage (P = 0.86). Smokers had greater rates of 30-day cellulitis (smoker: 1.6% vs. nonsmoker: 0.3%, P = 0.05) and DVT (smoker: 0.8% vs. nonsmoker: 0.0%, P = 0.02). Conclusions Our study suggests that smoking does not significantly affect 30-day readmission rates after complex spinal surgery requiring ≥3 levels of fusion. Further studies are necessary to corroborate our findings.

Original languageEnglish (US)
Pages (from-to)233-238
Number of pages6
JournalWorld Neurosurgery
Publication statusPublished - Nov 1 2017



  • 30-Day readmission
  • Complication
  • Deformity
  • Fusion
  • Smoking
  • Spine surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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