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- Title
The Relation Between Cigarette Smoking and Development of Sepsis: A 10-Year Follow-Up Study of Four Million Adults from the National Health Screening Program.
- Authors
Lee, Eun Hwa; Lee, Kyoung Hwa; Lee, Kyu-na; Park, Yebin; Do Han, Kyung; Han, Sang Hoon
- Abstract
Background: Sepsis remains a growing global health concern with soaring mortality and no direct anti-sepsis drug. Although smoking has distinct deleterious effects on chronic inflammatory illnesses and can impair immune function, a comprehensive analysis of the connection between sepsis and smoking is lacking. Methods: This large-scale longitudinal cohort study retrospectively assessed adults aged ≥ 20 years who underwent national health checkups under the Korean National Health Insurance Service between January and December 2009 (N = 4,234,415) and were followed up for 10 years. Sepsis was identified based on the International Classification of Diseases, 10th Revision codes, and smoking status, including accumulated amount, was collected through a self-administered questionnaire. The Cox proportional hazard regression model was used, adjusting for age, sex, household income, body mass index, drinking, exercise, diabetes, hypertension, dyslipidemia, and chronic renal disease. Results: After excluding cases with sepsis occurring before follow-up or after ≤ 1 year of follow-up, 3,881,958 participants, including non-smokers (N = 2,342,841), former smokers (N = 539,850), and active smokers (N = 999,267), were included. Compared to non-smokers, all active smokers (adjust hazard ratio: 1.41, 95% confidence interval 1.38–1.44) and former smokers (1.10, 1.07–1.14) with ≥ 20 pack-years exhibited a significantly higher risk of sepsis (p < 0.001). Smoking of ≥ 30 pack-years in former and active smokers groups significantly increased sepsis incidence (adjust hazard ratio [95% confidence interval] 1.34 [1.31–1.38], p < 0.001). Conclusions: Smoking is closely associated with the incidence of sepsis. Smoking cessation may help in the primary prevention of sepsis.
- Subjects
SEPSIS; SMOKING; NOSOLOGY; HEALTH programs; PROPORTIONAL hazards models; NATIONAL health insurance
- Publication
Journal of Epidemiology & Global Health, 2024, Vol 14, Issue 2, p444
- ISSN
2210-6006
- Publication type
Article
- DOI
10.1007/s44197-024-00197-6