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Postoperative risks associated with alcohol screening depend on documented drinking at the time of surgery

Rubinsky, Anna D; Bishop, Michael J; Maynard, Charles; Henderson, William G; Hawn, Mary T; Harris, Alex H S; Beste, Lauren A; Tønnesen, Hanne LU and Bradley, Katharine A (2013) In Drug and Alcohol Dependence 132(3). p.521-527
Abstract
Background
Both AUDIT-C alcohol screening scores up to a year before surgery and clinical documentation of drinking over 2 drinks per day immediately prior to surgery (“documented drinking >2 d/d”) are associated with increased postoperative complications and health care utilization. The purpose of this study was to evaluate whether documented drinking >2 d/d contributed additional information about postoperative risk beyond past-year AUDIT-C screening results.
Method
Male Veterans Affairs (VA) patients who had a non-emergent, non-cardiac, major surgery assessed by the VA's Surgical Quality Improvement Program 10/2003-9/2006 and completed the AUDIT-C by mailed survey in the prior year were eligible for this study. Linear... (More)
Background
Both AUDIT-C alcohol screening scores up to a year before surgery and clinical documentation of drinking over 2 drinks per day immediately prior to surgery (“documented drinking >2 d/d”) are associated with increased postoperative complications and health care utilization. The purpose of this study was to evaluate whether documented drinking >2 d/d contributed additional information about postoperative risk beyond past-year AUDIT-C screening results.
Method
Male Veterans Affairs (VA) patients who had a non-emergent, non-cardiac, major surgery assessed by the VA's Surgical Quality Improvement Program 10/2003-9/2006 and completed the AUDIT-C by mailed survey in the prior year were eligible for this study. Linear or logistic regression models compared 30-day postoperative complication(s), return to operating room (OR), hospital length of stay (LOS), and intensive care unit (ICU) days across eight groups defined by past-year AUDIT-C score and clinically documented drinking >2 d/d, with AUDIT-C scores 1–4 and no documented drinking >2 d/d as the referent, after adjusting for important covariates.
Results
Overall 8811 patients met inclusion criteria. Among patients with documented drinking >2 d/d immediately prior to surgery, postoperative risk varied widely depending on past-year AUDIT-C score; scores ≥5 were associated with increased risk of complication(s), and scores ≥9 with increased hospital LOS and ICU days. Among patients without documentation of drinking >2 d/d, increasing AUDIT-C scores were not associated with these outcomes.
Conclusions
Clinical documentation of drinking >2 d/d immediately prior to surgery contributed additional information about postoperative risk beyond past-year AUDIT-C score. However, among patients with documented drinking >2 d/d, postoperative risk varied widely depending on the AUDIT-C score. (Less)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
subject
in
Drug and Alcohol Dependence
volume
132
issue
3
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:84883559517
ISSN
0376-8716
DOI
10.1016/j.drugalcdep.2013.03.022
language
English
LU publication?
no
id
a47daa4d-3295-447e-a850-0eb18a5b8060
date added to LUP
2018-12-06 15:31:26
date last changed
2019-02-20 11:39:12
@article{a47daa4d-3295-447e-a850-0eb18a5b8060,
  abstract     = {Background<br>
Both AUDIT-C alcohol screening scores up to a year before surgery and clinical documentation of drinking over 2 drinks per day immediately prior to surgery (“documented drinking &gt;2 d/d”) are associated with increased postoperative complications and health care utilization. The purpose of this study was to evaluate whether documented drinking &gt;2 d/d contributed additional information about postoperative risk beyond past-year AUDIT-C screening results.<br>
Method<br>
Male Veterans Affairs (VA) patients who had a non-emergent, non-cardiac, major surgery assessed by the VA's Surgical Quality Improvement Program 10/2003-9/2006 and completed the AUDIT-C by mailed survey in the prior year were eligible for this study. Linear or logistic regression models compared 30-day postoperative complication(s), return to operating room (OR), hospital length of stay (LOS), and intensive care unit (ICU) days across eight groups defined by past-year AUDIT-C score and clinically documented drinking &gt;2 d/d, with AUDIT-C scores 1–4 and no documented drinking &gt;2 d/d as the referent, after adjusting for important covariates.<br>
Results<br>
Overall 8811 patients met inclusion criteria. Among patients with documented drinking &gt;2 d/d immediately prior to surgery, postoperative risk varied widely depending on past-year AUDIT-C score; scores ≥5 were associated with increased risk of complication(s), and scores ≥9 with increased hospital LOS and ICU days. Among patients without documentation of drinking &gt;2 d/d, increasing AUDIT-C scores were not associated with these outcomes.<br>
Conclusions<br>
Clinical documentation of drinking &gt;2 d/d immediately prior to surgery contributed additional information about postoperative risk beyond past-year AUDIT-C score. However, among patients with documented drinking &gt;2 d/d, postoperative risk varied widely depending on the AUDIT-C score.},
  author       = {Rubinsky, Anna D and Bishop, Michael J and Maynard, Charles and Henderson, William G and Hawn, Mary T and Harris, Alex H S and Beste, Lauren A and Tønnesen, Hanne and Bradley, Katharine A},
  issn         = {0376-8716},
  language     = {eng},
  month        = {10},
  number       = {3},
  pages        = {521--527},
  publisher    = {Elsevier},
  series       = {Drug and Alcohol Dependence},
  title        = {Postoperative risks associated with alcohol screening depend on documented drinking at the time of surgery},
  url          = {http://dx.doi.org/10.1016/j.drugalcdep.2013.03.022},
  volume       = {132},
  year         = {2013},
}