ObjectiveTo evaluate the effect of smoking and drinking status on the prognosis of patients with esophageal squamous cell carcinoma (ESCC).MethodsThe clinical data of 483 patients with ESCC who underwent surgical treatment in Shannxi Provincial People's Hospital from 2007 to 2016 were retrospectively analyzed. Among them, 352 patients were male and 131 were female, with a median age of 64 (37-80) years. There were 311 smokers and 172 drinkers. The relationship between preoperative drinking or smoking status and the clinicopathological characteristics of patients with ESCC was analyzed. Log-rank method and Cox risk regression were used to conduct univariate and multivariate survival analysis, respectively.ResultsThe preoperative smoking status was related to the patient's tumor location (P=0.030). Drinking status was associated with tumor location (P=0.001), degree of differentiation (P=0.030), pathological T stage (P=0.024) and pathological N stage (P=0.029). Univariate survival analysis showed that smoking status did not affect the disease-free survival (DFS) (P=0.188) and overall survival (OS) (P=0.127) of patients with ESCC. However, patients who drank alcohol had worse PFS than non-drinking patients (29.37 months vs. 42.87 months, P=0.009). It was further proved that alcohol consumption was an independent risk factor affecting patients' recurrence and metastasis by using multivariate analysis (RR=1.28, P=0.040). Alcohol consumption also reduced the OS of patients by 21.47 months (P=0.014), however, multivariate analysis did not yield significant results.ConclusionPreoperative drinking status is related to the stage and differentiation of patients with ESCC. It is an independent risk factor affecting the recurrence and metastasis of ESCC.
ObjectiveTo investigate the effects of alcohol consumption status and labor intensity on the tolerance of patients undergoing bronchoscopy under mild to moderate sedation anesthesia. MethodsAdult patients scheduled for bronchoscopy under local anesthesia or mild to moderate sedation were included, and their clinical characteristics and bronchoscopy tolerance were recorded. The study compared changes in vital signs, severity of coughing, and procedure failure rates during bronchoscopy among patients with different drinking statuses (non-drinkers, former drinkers, and current drinkers) and different labor intensities (light, moderate, and heavy labor intensity) to assess the impact of drinking status and labor intensity on bronchoscopy tolerance.ResultsA total of 142 subjects were included in the study, with 50 patients receiving local anesthesia and 92 patients receiving mild to moderate sedation. Current drinkers had a higher procedure failure rate (2.9% vs. 1.9% vs. 25.0%, P<0.01, for non-drinkers, former drinkers, and current drinkers, respectively) and more significant intraoperative blood pressure drops (systolic pressure change, −3.5±9.1 vs. −0.2±8.1 vs. −9.3±17.9 mm Hg, P<0.01; diastolic pressure change, −0.5±5.6 vs. 2.9±7.9 vs. −3.2±12.4, P<0.05). Patients with moderate to heavy labor intensity also had higher procedure failure rates and more pronounced intraoperative blood pressure drops (procedure failure rate, 1.1% vs. 13.2% vs. 22.2%, P<0.01, for light, moderate, and heavy labor intensity, respectively; intraoperative systolic pressure change, −1.8±8.5 vs. 2.8±8.5 vs. −17.2±24.7 mm Hg, P<0.001; intraoperative diastolic pressure change, 1.3±6.4 vs. 0.2±6.7 vs. −8.1±17.2 mm Hg, P<0.01). The impact of drinking status and labor intensity on procedure tolerance was only observed in patients receiving mild to moderate sedation. After controlling for relevant confounding factors, current drinking and moderate to heavy labor intensity were identified as independent risk factors for procedure failure (current drinkers compared to non-drinkers or former drinkers, OR 47.2, 95%CI: 3.1-232.2, P<0.05; moderate to heavy labor intensity compared to low labor intensity, OR 25.7, 95%CI: 2.8-67.7, P<0.05).ConclusionsCurrent drinkers engaged in moderate to heavy labor intensity are less likely to tolerate bronchoscopy under mild to moderate sedation. It is essential to pay attention to the selection and evaluation of anesthesia methods, procedure types, and intraoperative monitoring for this population.