The risk factors for failure of an upper extremity replantation: Is the use of cigarettes/tobacco a significant factor?

Ji Yin He, Shih Heng Chen, Tsu Min Tsai

Research output: Contribution to journalJournal Article peer-review

15 Scopus citations


Background The purpose of this study was to explore the potential risk factors associated with the failure of an upper extremity replantation with a focus on cigarette or tobacco use. Patients and Methods A cohort of 102 patients with 149 replants (6 extremities, 143 digits) and a mean age of 41 years (range 5 to 72 years) was enrolled in this study. The data collected included age, gender, tobacco/cigarettes use, trauma mechanism, underlying disease (e.g., hypertension (HTN), diabetes mellitus (DM), etc.), and vein graft use. An analysis with a multivariable regression was conducted to identify the risk factors of replant failure and their respective odds ratios (ORs). Results Multilevel generalized linear mixed models (GLMMs) with a binomial distribution and logit link showed that smoking did not increase the risk of replant failure (p = 0.234). In addition, the survival of replants was not affected by DM or HTN (p = 0.285 and 0.938, respectively). However, the replantation results were significantly affected by the age of the patients and the mechanism of injury. Patients older than 50 years and those with avulsion or crush injuries tended to have a higher risk of replant failure (OR = 2.29, 6.45, and 5.42, respectively; p = 0.047, 0.028, and 0.032, respectively). Conclusions This study showed that the use of cigarettes/tobacco did not affect the replantation outcome. The main risks for replant failure included being older than 50 years and the trauma mechanism (avulsion or crush injuries).

Original languageEnglish
Article numbere0141451
JournalPLoS ONE
Issue number10
StatePublished - 29 10 2015

Bibliographical note

Publisher Copyright:
© 2015 He et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Dive into the research topics of 'The risk factors for failure of an upper extremity replantation: Is the use of cigarettes/tobacco a significant factor?'. Together they form a unique fingerprint.

Cite this