Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes
| Autor: | Miquel Navasa, Antoni Gual, Elsa Caballeria, Hugo López-Pelayo, Gonzalo Crespo, E. López, Anna Lligoña, Jordi Colmenero, Ana Isabel López-Lazcano |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment lcsh:Medicine Alcohol use disorder 030230 surgery Liver transplantation alcohol use disorder survival Article smoking 03 medical and health sciences Liver disease 0302 clinical medicine Internal medicine medicine Risk of mortality risk factors business.industry lcsh:R Retrospective cohort study General Medicine medicine.disease Substance abuse Transplantation liver transplant 030211 gastroenterology & hepatology business Alcohol Abstinence |
| Zdroj: | Journal of Clinical Medicine, Vol 9, Iss 2710, p 2710 (2020) Journal of Clinical Medicine Volume 9 Issue 9 |
| ISSN: | 2077-0383 |
| Popis: | Tobacco use is more prevalent among alcohol liver disease (ALD) transplant patients and exerts harmful effects to the patient and to the graft. The aims of this study were to examine the impact of smoking status (nonsmoker, ex-smoker, active smoker) on patient survival and clinical outcomes, and to assess risk factors for active smoking before and after liver transplant (LT). An observational retrospective cohort study with 314 ALD patients undergoing LT from January 2004 to April 2016. Recipients were followed until April 2017 or death. Kaplan&ndash Meier and Cox proportional hazards regression analyses were used to assess risk of mortality according to smoking status before LT. Smokers had a 79% higher risk of dying than those who had never smoked or quit smoking before LT. Ex-smokers had a greater survival probability (96.2%, 93.8%, 86.9%, and 83.1% at 1, 3, 5, and 10 years after LT) than active smokers until LT (96.0%, 85.6%, 80.0%, and 70.4%). Active smokers before LT with poor toxicity awareness had more than a twofold higher risk of mortality (Cox HR = 2.20, 95% CI: 1.05&ndash 4.58, p = 0.04) than ex-smokers. Younger age (OR = 94), higher Model for End-Stage Liver Disease (MELD) (OR = 1.06), and comorbid substance use disorder (OR = 2.35) were predictors of smoking until LT. Six months or less of alcohol abstinence (OR = 3.23), and comorbid substance use disorder (OR = 4.87) were predictors of active smoking after LT. Quitting smoking before transplantation improved survival. Evidence based smoking cessation interventions should be offered before and after LT. |
| Databáze: | OpenAIRE |
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