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Title: Smoking Associated With Increased Risk of Haemorrhage After Throat Surgery
URL: http://www.pslgroup.com/dg/2294EE.htm
Doctor's Guide
August 18, 2008


CHICAGO -- August 18, 2008 -- Smoking appears to be associated with an increased rate of haemorrhage in patients who undergo uvulopalatopharyngoplasty (UPPP) with tonsillectomy, but not in those who undergo tonsillectomy alone, according to a report in the August issue of Archives of Otolaryngology - Head & Neck Surgery.

Sean M. Demars, MD, then of Madigan Army Medical Center, Tacoma, Washington, and now of Bassett Army Community Hospital, Fort Wainwright, Alaska, and colleagues evaluated the rate of postoperative bleeding in 1,010 tonsillectomy patients from 2000 to 2005. Age, sex, and smoking status were also noted.

The total bleeding rate for all patients was 6.7%. When smoking was factored in, the bleeding rate for patients who smoked was 10.2% and 5.4% for nonsmokers.

The large difference was found "to be attributable to a marked increase in postoperative haemorrhage in the patients who underwent UPPP (10.9% in smokers vs 3.3% in nonsmokers)," the authors wrote. In addition, "men who underwent tonsillectomy alone bled significantly more than women (11.2% vs 5.4%)."

Awareness of the association between smoking and postoperative haemorrhage "may help clinicians further counsel their patients before surgery," the authors concluded. "Further investigation of this relationship is needed, with stratification of patients by the number of cigarettes smoked and attention to the length of time before and/or after surgery that patients refrain from smoking."

SOURCE: Journal of the American Medical Association

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