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PATIENT SAFETY

Substance Use Among Iranian Cardiac Surgery Patients and Its Effects on Short-Term Outcome

From the Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Address correspondence and reprint requests to Rasoul Azarfarin, MD, Cardiovascular Research Center, Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. Address e-mail to azarfarinr{at}tbzmed.ac.ir.

Abstract

BACKGROUND: We assessed the prevalence of substance use among patients undergoing coronary artery bypass graft and valve surgery in northwest Iran. We evaluated the postoperative complications and in-hospital mortality of patients with substance dependence and abuse.

METHODS: In this prospective, observational study, we interviewed 600 patients during the preoperative visit in a tertiary referral educational hospital in northwest Iran. The definition of substance abuse and dependence was according to DSM-IV criteria. Postoperative complications and in-hospital mortality of patients with substance (cigarette, opium, and alcohol) dependence and abuse were compared with those in control patients who did not use these substances.

RESULTS: In 600 studied patients, the prevalence of cigarette smoking was 42.1% (ex-smokers 26.0% and current smokers 16.1%), prevalence of opium use was 12.0% (opium abuse 7.0% and opium dependence 5.0%), and alcohol consumption was 8.1% (alcohol abuse 7.4% and alcohol dependence 0.7%). The prevalence of cigarette smoking was 58.9% in men and 7.6% in women (P = 0.001). Postoperative cardiac complications in current smokers (21.5%) and ex-smokers (20.5%) were not significantly different from the control group (28.2%). Also, pulmonary complications were not different in current smokers (24.7%) and ex-smokers (17.9%) from the control group (26.8%; P = 0.196). However, in men, pulmonary complications in current smokers were more prevalent than in the control group (P = 0.044). In opium and alcohol dependents and abusers, postoperative complications were not statistically different from the control group (all P values >0.05). No increase was observed regarding in-hospital mortality in patients with substance use.

CONCLUSIONS: In cardiac surgery patients in northwest Iran, the prevalence of cigarette smoking is relatively low (very low in women), as is alcohol use, compared with Western countries; however, opium use is twice as prevalent. We found higher pulmonary complication rates in men who smoked, but no increase in postoperative cardiopulmonary complications and in-hospital mortality rates in patients who abused opium and consumed alcohol.

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