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Research Summary

Preoperative Unhealthy Alcohol Use Increases Surgical Risk

Prior research has suggested that unhealthy alcohol use is a modifiable risk factor for perioperative complications. This study examined 9176 male veterans who underwent major noncardiac surgery in the Veterans Affairs (VA) Surgical Quality Improvement Program between 2004–2006 and who completed the AUDIT-C* as part of a VA mailed survey in the 12 months prior to surgery.

  • Sixteen percent of patients screened positive for unhealthy alcohol use (AUDIT-C score >5).
  • After adjusting for age, smoking, and days from screening to surgery, the prevalence of postoperative complications increased with increasing AUDIT-C score:
AUDIT-C Score
Rate of Postoperative Complications
1–4
5.6%
5–8
7.9%
9–10
9.7%
11–12
14.0%
*Alcohol Use Disorders Identification Test—Consumption.

Comments:

The AUDIT-C can risk-stratify preoperative patients for postoperative complications up to a year prior to surgery. Extrapolating from other research, primary care providers should counsel patients with AUDIT-C scores >5 who are contemplating surgery about the postoperative risks and encourage them to abstain for at least a month preoperatively. Peter D. Friedmann, MD, MPH

Reference:

Bradley KA, Rubinsky AD, Sun H, et al. Alcohol screening and risk of postoperative complications in male VA patients undergoing major non-cardiac surgery. J Gen Intern Med. 2011;26(2):162–169.

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