Abstract

SCHONFELD, Daniel et al. Indicación de cesación tabáquica en la evaluación preoperatoria: conociendo la realidad de nuestra práctica. Rev. am. med. respir. [online]. 2016, vol.16, n.4, pp.341-349. ISSN 1852-236X.

Introduction: Smoking can be a causal factor of multiple complications after surgery. The pre-surgical period is key for smoking patients to quit. According to different evidence-based medicine (EBM) interventions, postoperative follow-up to corroborate quitting stimulates sustainable smoking cessation. However, not all professionals follow these recommendations in their practice. Objectives: to determine how physicians act with smoking patients referred for surgical risk evaluation, which interventions they apply and to what extent they are evidence-based. Material and methods: it is an observational, prospective, cross-sectional design. Physicians attending a congress of respiratory medicine were voluntarily and anonymously interviewed. The questionnaire was designed for this research and it was validated by the Delphi method. It has 15 multiple-choice questions except for the last domain which requests mentioning bibliography supporting their behavior. Results: 152 surveys were collected. Respondents were mostly pulmonologists and over 30 years of age. 86 (66.7%) were women. Almost 50% performed surgical risk assessments on 2 to 10 patients per week. In the case of current smokers, over 80% of physicians advised smoking cessation. 54.6% recommended an 8 week smoking-free interval prior to surgery; and 62% applied a mixed (pharmacological and verbal) approach. 74.8% of this group referred they monitored patients postoperatively. More than half respondents said that their recommendations were empirical and only 15.8 per cent quoted reference bibliography. Conclusions: Most respondents agree to the need to indicate smoking cessation in the preoperative evaluation but only 15.8% mentioned bibliography that supports their recommendation. We can conclude that scientific associations related with surgical risk evaluation should include this subject in their continuous medical education programs in order to reduce postop complications and foster smoking cessation.

Keywords : Preoperative evaluation; Smoking; Smoking cessation; Surgical risk.

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