BACKGROUND: Patients who misuse alcohol are at increased risk for surgical complications. Four weeks of preoperative abstinence decreases the risk of complications, but practical approaches for early preoperative identification of alcohol misuse are needed. OBJECTIVE: To evaluate whether results of alcohol screening with the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) questionnaire-up to a year before surgery-were associated with the risk of postoperative complications. DESIGN: This is a cohort study. SETTING AND PARTICIPANTS: Male Veterans Affairs (VA) patients were eligible if they had major noncardiac surgery assessed by the VA's Surgical Quality Improvement Program (VASQIP) in fiscal years 2004-2006, and completed the AUDIT-C alcohol screening questionnaire (0-12 points) on a mailed survey within 1 year before surgery. MAIN OUTCOME MEASURE: One or more postoperative complication(s) within 30 days of surgery based on VASQIP nurse medical record reviews. RESULTS: Among 9,176 eligible men, 16.3% screened positive for alcohol misuse with AUDIT-C scores ≥ 5, and 7.8% had postoperative complications. Patients with AUDIT-C scores ≥ 5 were at significantly increased risk for postoperative complications, compared to patients who drank less. In analyses adjusted for age, smoking, and days from screening to surgery, the estimated prevalence of postoperative complications increased from 5.6% (95% CI 4.8-6.6%) in patients with AUDIT-C scores 1-4, to 7.9% (6.3-9.7%) in patients with AUDIT-Cs 5-8, 9.7% (6.6-14.1%) in patients with AUDIT-Cs 9-10 and 14.0% (8.9-21.3%) in patients with AUDIT-Cs 11-12. In fully-adjusted analyses that included preoperative covariates potentially in the causal pathway between alcohol misuse and complications, the estimated prevalence of postoperative complications increased significantly from 4.8% (4.1-5.7%) in patients with AUDIT-C scores 1-4, to 6.9% (5.5-8.7%) in patients with AUDIT-Cs 5-8 and 7.5% (5.0-11.3%) among those with AUDIT-Cs 9-10. CONCLUSIONS: AUDIT-C scores of 5 or more up to a year before surgery were associated with increased postoperative complications.
BACKGROUND:Patients who misuse alcohol are at increased risk for surgical complications. Four weeks of preoperative abstinence decreases the risk of complications, but practical approaches for early preoperative identification of alcohol misuse are needed. OBJECTIVE: To evaluate whether results of alcohol screening with the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) questionnaire-up to a year before surgery-were associated with the risk of postoperative complications. DESIGN: This is a cohort study. SETTING AND PARTICIPANTS: Male Veterans Affairs (VA) patients were eligible if they had major noncardiac surgery assessed by the VA's Surgical Quality Improvement Program (VASQIP) in fiscal years 2004-2006, and completed the AUDIT-Calcohol screening questionnaire (0-12 points) on a mailed survey within 1 year before surgery. MAIN OUTCOME MEASURE: One or more postoperative complication(s) within 30 days of surgery based on VASQIP nurse medical record reviews. RESULTS: Among 9,176 eligible men, 16.3% screened positive for alcohol misuse with AUDIT-C scores ≥ 5, and 7.8% had postoperative complications. Patients with AUDIT-C scores ≥ 5 were at significantly increased risk for postoperative complications, compared to patients who drank less. In analyses adjusted for age, smoking, and days from screening to surgery, the estimated prevalence of postoperative complications increased from 5.6% (95% CI 4.8-6.6%) in patients with AUDIT-C scores 1-4, to 7.9% (6.3-9.7%) in patients with AUDIT-Cs 5-8, 9.7% (6.6-14.1%) in patients with AUDIT-Cs 9-10 and 14.0% (8.9-21.3%) in patients with AUDIT-Cs 11-12. In fully-adjusted analyses that included preoperative covariates potentially in the causal pathway between alcohol misuse and complications, the estimated prevalence of postoperative complications increased significantly from 4.8% (4.1-5.7%) in patients with AUDIT-C scores 1-4, to 6.9% (5.5-8.7%) in patients with AUDIT-Cs 5-8 and 7.5% (5.0-11.3%) among those with AUDIT-Cs 9-10. CONCLUSIONS:AUDIT-C scores of 5 or more up to a year before surgery were associated with increased postoperative complications.
Authors: M J Martin; C Heymann; T Neumann; L Schmidt; F Soost; B Mazurek; B Böhm; C Marks; K Helling; E Lenzenhuber; C Müller; W J Kox; C D Spies Journal: Alcohol Clin Exp Res Date: 2002-06 Impact factor: 3.455
Authors: Peter M Miller; Claudia Spies; Tim Neumann; Martin A Javors; A M Hoyumpa; John Roache; Amy Webb; Maryam Kashi; Francis E Sharkey; Raymond F Anton; Brent M Egan; Jan Basile; Shaun Nguyen; Michael F Fleming; Kathryn Sullivan Dillie Journal: Alcohol Clin Exp Res Date: 2006-02 Impact factor: 3.455
Authors: Katharine A Bradley; Emily C Williams; Carol E Achtmeyer; Eric J Hawkins; Alex H S Harris; Madeleine S Frey; Thomas Craig; Daniel R Kivlahan Journal: Subst Abus Date: 2007 Impact factor: 3.716
Authors: David H Au; Daniel R Kivlahan; Chris L Bryson; David Blough; Katharine A Bradley Journal: Alcohol Clin Exp Res Date: 2007-03 Impact factor: 3.455
Authors: Eric J Hawkins; Daniel R Kivlahan; Emily C Williams; Steven M Wright; Thomas Craig; Katharine A Bradley Journal: Subst Abus Date: 2007 Impact factor: 3.716
Authors: Gerard Williams; Michelle Daly; Elizabeth M Proude; Steven Kermode; Michelle Davis; Jan Barling; Paul S Haber Journal: Drug Alcohol Rev Date: 2008-01
Authors: Leslie S Kinder; Chris L Bryson; Haili Sun; Emily C Williams; Katharine A Bradley Journal: J Stud Alcohol Drugs Date: 2009-03 Impact factor: 2.582
Authors: Shukri F Khuri; William G Henderson; Jennifer Daley; Olga Jonasson; R Scott Jones; Darrell A Campbell; Aaron S Fink; Robert M Mentzer; Leigh Neumayer; Karl Hammermeister; Cecilia Mosca; Nancy Healey Journal: Ann Surg Date: 2008-08 Impact factor: 12.969
Authors: Adam Atherly; Aaron S Fink; Darrell C Campbell; Robert M Mentzer; William Henderson; Shukri Khuri; Steven D Culler Journal: Am J Surg Date: 2004-11 Impact factor: 2.565
Authors: Brenda J Curtis; Sara Hlavin; Aleah L Brubaker; Elizabeth J Kovacs; Katherine A Radek Journal: Alcohol Clin Exp Res Date: 2014-04-01 Impact factor: 3.455
Authors: Lauren Matukaitis Broyles; Adam J Gordon; Susan M Sereika; Christopher M Ryan; Judith A Erlen Journal: Subst Abus Date: 2011-10 Impact factor: 3.716
Authors: Kira L Newman; Kay M Johnson; Paul B Cornia; Peter Wu; Kamal Itani; George N Ioannou Journal: Clin Gastroenterol Hepatol Date: 2019-07-31 Impact factor: 11.382
Authors: Brendan J Clark; Anna D Rubinsky; P Michael Ho; David H Au; Laura J Chavez; Marc Moss; Katharine A Bradley Journal: Subst Abus Date: 2016-01-05 Impact factor: 3.716
Authors: Laura J Chavez; Chuan-Fen Liu; Nathan Tefft; Paul L Hebert; Brendan J Clark; Anna D Rubinsky; Gwen T Lapham; Katharine A Bradley Journal: Drug Alcohol Depend Date: 2015-11-19 Impact factor: 4.492