Smoking and Surgical Site Infection in Orthopedic Patients' Lower Extremity Arthroplasty
Examining the Association Between Smoking Status and Surgical Site Infections in Total Knee Arthroplasty Patients Using Andersen's Behavioral Model
Abstract
Cigarette smoking has been a public health concern for many years, and the potential impact of smoking on surgical site infections (SSIs) has been widely studied. However, a gap in understanding persists regarding whether an association exists between tobacco smoking and the development of SSIs among patients undergoing lower extremity surgery, specifically total knee arthroplasty (TKA).
The purpose of this study was to examine the association between smoking and lower extremity SSIs. Andersen's Behavioral Model (BM) was used to understand the risk factors relevant to the interaction between smoking and SSIs. Application of the BM categories—predisposing, enabling, need, and behavioral factors—facilitated discussion of surgical outcomes.
A quantitative, cross-sectional approach was used to analyze data from a legacy registry at an East Coast hospital. The research question addressed whether smoking status across three groups (i.e., smokers, nonsmokers, and former smokers), along with variables within the BM categories—including predisposing variables such as age, gender, and body mass index (BMI); enabling variables such as healthcare insurance coverage; and need variables including diabetes, hypertension, deficiency anemia, rheumatoid arthritis (RA), and other health diagnoses—was associated with postoperative SSI.
Multiple logistic regression analysis was performed, and no statistically significant association was found between smoking status and SSI. However, RA demonstrated a significant association with SSI.
Positive social change may result from disseminating new knowledge aimed at reducing the financial burden associated with the prevalence of SSI through behavioral changes and improvements in overall health and wellness.
