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Our objective was to investigate the effect of smoking on postoperative wound complications for major surgeries. Data were collected from the 2013 to 2018 participant use files of the American College of Surgeons National Surgical Quality Improvement Program database. A propensity score matching procedure was used to create the balanced smoker and nonsmoker groups. Multivariable logistic regression was used to calculate the odds ratios (ORs) with 95% confidence intervals (CIs) for postoperative wound complications, pulmonary complications, and in\u2010hospital mortality associated with smokers. A total of 1\u2009156\u2009002 patients (578\u2009001 smokers and 578\u2009001 nonsmokers) were included in the propensity score matching analysis. Smoking was associated with a significantly increased risk of postoperative wound disruption (OR 1.65, 95% CI 1.56\u20101.75), surgical site infection (OR 1.31, 95% CI 1.28\u20101.34), reintubation (OR 1.47, 95% CI 1.40\u20101.54), and in\u2010hospital mortality (OR 1.13, 95% CI 1.07\u20101.19) compared with nonsmoking. The length of hospital stay was significantly increased in smokers compared with nonsmokers. Our analysis indicates that smoking is associated with an increased risk of surgical site infection, wound disruption, and postoperative pulmonary complications. The results may drive the clinicians to encourage patients to quit smoking before surgery.<\/jats:p>","DOI":"10.1111\/iwj.13887","type":"journal-article","created":{"date-parts":[[2022,7,9]],"date-time":"2022-07-09T03:59:22Z","timestamp":1657339162000},"page":"391-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":95,"title":["Smoking increases the risk of postoperative wound complications: A propensity score\u2010matched cohort study"],"prefix":"10.1111","volume":"20","author":[{"given":"Yu\u2010Hsuan","family":"Fan Chiang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Taipei Medical University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5013-2912","authenticated-orcid":false,"given":"Yuan\u2010Wen","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Taipei Medical University Hospital 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