{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:59:59Z","timestamp":1792432799466,"version":"4.5.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There have been conflicting reports regarding the effect of smoking on complications after surgical treatment of ankle fractures. This study aimed at identifying the complications for which smokers and subgroups of smokers are at a higher risk compared to nonsmokers when undergoing surgery for fixation of rotational ankle fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The American College of Surgeons National Surgical Quality Improvement Program data set from 2008 to 2019 was used to compare the 30-day wound, cardiac, renal, and infectious complications, related readmissions, and return to the operating room between the 2 cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 33\u2009741 patients included, 25\u2009642 (76.0%) were nonsmokers and 8099 (24.0%) were smokers. Multivariate analysis showed that smokers were at a higher risk for deep wound infection (OR 2.34, 95% CI 1.48-3.69,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), wound dehiscence (OR 2.43, 95% CI 1.56-3.77,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), related return to the operating room (OR 1.69, 95% CI 1.36-2.11,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and related readmissions (OR 1.67, 95% CI 1.32-2.09,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Smokers at an increased risk for deep infection included patients between 50 and 59 years (OR 5.75, 95% CI 1.78-18.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003), who were Black (OR 4.24, 95% CI 1.04-17.23,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .044), who had body mass index (BMI) 35 to 39.9 (OR 3.73, 95% CI 1.46-9.50,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .006), or operative times between 60 and 90 minutes (OR 3.64, 95% CI 1.79-7.39,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Smoker subgroups at a higher risk for wound dehiscence included patients between 50 and 59 years (OR 9.86, 95% CI 3.29-29.53,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), with operative times between 90 and 120 minutes (OR 4.88, 95% CI 1.89-12.58,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), with BMI 30 to 34.9 (OR 3.06, 95% CI 1.45-6.45,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003) and who underwent spinal\/epidural anesthesia (OR 9.31, 95% CI 2.31-37.58,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Smokers were at an increased risk for deep wound infection, wound dehiscence, related reoperations, and related readmissions after ankle fracture surgery. Certain subgroups were at an even higher risk for these complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114221115677","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T02:47:06Z","timestamp":1659494826000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Comparing the 30-Day Complications Between Smokers and Nonsmokers Undergoing Surgical Fixation of Ankle Fractures"],"prefix":"10.1177","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5359-9027","authenticated-orcid":false,"given":"Bernard H.","family":"Sagherian","sequence":"first","affiliation":[{"name":"Division of Orthopedic Surgery, Department of Surgery, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6900-5462","authenticated-orcid":false,"given":"Jawad J.","family":"Hoballah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Tamim","sequence":"additional","affiliation":[{"name":"Biostatistics Unit in the Clinical Research Institute, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100720971269."},{"key":"e_1_3_2_3_2","unstructured":"American College of Surgeons. 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