Minor effect of patient education for alcohol cessation intervention on outcomes after acute fracture surgery: a randomized trial of 70 patients
(2022) In Acta Orthopaedica 93. p.424-431- Abstract
- Background and purpose — High alcohol intake is associated with increased risk of postoperative complications. Alcohol cessation intervention is recommended prior to elective surgery. We investigated short- and long-term effects of perioperative intensive alcohol intervention in relation to acute ankle fracture surgery.
Patients and methods — 70 patients requiring ankle fracture surgery and consuming ≥ 21 drinks weekly (1 drink = 12 g ethanol) were randomized to a manual-based 6-week intensive standardized alcohol cessation program, the Gold Standard Program (GSP-A), or treatment as usual (TAU), on the day of operation. GSP-A included 5 personal meetings, patient education, and motivational and pharmacological support (alcohol... (More) - Background and purpose — High alcohol intake is associated with increased risk of postoperative complications. Alcohol cessation intervention is recommended prior to elective surgery. We investigated short- and long-term effects of perioperative intensive alcohol intervention in relation to acute ankle fracture surgery.
Patients and methods — 70 patients requiring ankle fracture surgery and consuming ≥ 21 drinks weekly (1 drink = 12 g ethanol) were randomized to a manual-based 6-week intensive standardized alcohol cessation program, the Gold Standard Program (GSP-A), or treatment as usual (TAU), on the day of operation. GSP-A included 5 personal meetings, patient education, and motivational and pharmacological support (alcohol withdrawal prophylaxis, B vitamins, and low-dose disulfiram). Complications requiring treatment were measured after 6 weeks and 1 year. Alcohol intake was validated by biomarkers. Quality of life (QoL) was measured by the SF-36. Hospital costs were obtained from the National Hospital Costs Register.
Results — Postoperatively, complete alcohol cessation was higher in the GSP-A than in the TAU group (18/35 vs. 5/35, number needed to treat = 3, p ≤ 0.001), but not low risk consumption in the long term (10/35 vs. 7/33, p = 0.5). Number of complications in the short and long term (12/35 vs. 14/33, 16/35 vs. 18/33), the SF-36 score, or hospital costs in the short and long term (€6,294 vs. €8,024, €10,662 vs. €12,198), were similar between the groups.
Interpretation — Despite an effect on alcohol cessation and a positive tendency as regards the other outcomes, the postoperative complications, QoL, and costs were similar. Better perioperative strategies for acute surgical patients with high alcohol intake therefore need to be developed. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/f194f6e7-1d1c-456d-af26-1d211228bfd0
- author
- Weber Melchior Egholm, Julie ; Pedersen, Bolette LU ; Oppedal, Kristian ; Madsen, Bjørn Lindegård ; Lauritzen, Jes Bruun ; Rasmussen, Mette LU ; Helander, Anders ; Adami, Johanna and Tønnesen, Hanne LU
- organization
- publishing date
- 2022-04-12
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Acta Orthopaedica
- volume
- 93
- pages
- 424 - 431
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:35417027
- scopus:85128117121
- ISSN
- 1745-3682
- DOI
- 10.2340/17453674.2022.2482
- project
- Scand-Ankle: Utveckling av ett evidensbaserat utbildningsprogram för patienter med hög alkoholkonsumtion och fotledsfrakturer i Skandinavien.
- language
- English
- LU publication?
- yes
- id
- f194f6e7-1d1c-456d-af26-1d211228bfd0
- date added to LUP
- 2022-04-21 14:27:14
- date last changed
- 2024-02-25 16:45:03
@article{f194f6e7-1d1c-456d-af26-1d211228bfd0, abstract = {{Background and purpose — High alcohol intake is associated with increased risk of postoperative complications. Alcohol cessation intervention is recommended prior to elective surgery. We investigated short- and long-term effects of perioperative intensive alcohol intervention in relation to acute ankle fracture surgery.<br/><br/>Patients and methods — 70 patients requiring ankle fracture surgery and consuming ≥ 21 drinks weekly (1 drink = 12 g ethanol) were randomized to a manual-based 6-week intensive standardized alcohol cessation program, the Gold Standard Program (GSP-A), or treatment as usual (TAU), on the day of operation. GSP-A included 5 personal meetings, patient education, and motivational and pharmacological support (alcohol withdrawal prophylaxis, B vitamins, and low-dose disulfiram). Complications requiring treatment were measured after 6 weeks and 1 year. Alcohol intake was validated by biomarkers. Quality of life (QoL) was measured by the SF-36. Hospital costs were obtained from the National Hospital Costs Register.<br/><br/>Results — Postoperatively, complete alcohol cessation was higher in the GSP-A than in the TAU group (18/35 vs. 5/35, number needed to treat = 3, p ≤ 0.001), but not low risk consumption in the long term (10/35 vs. 7/33, p = 0.5). Number of complications in the short and long term (12/35 vs. 14/33, 16/35 vs. 18/33), the SF-36 score, or hospital costs in the short and long term (€6,294 vs. €8,024, €10,662 vs. €12,198), were similar between the groups.<br/><br/>Interpretation — Despite an effect on alcohol cessation and a positive tendency as regards the other outcomes, the postoperative complications, QoL, and costs were similar. Better perioperative strategies for acute surgical patients with high alcohol intake therefore need to be developed.}}, author = {{Weber Melchior Egholm, Julie and Pedersen, Bolette and Oppedal, Kristian and Madsen, Bjørn Lindegård and Lauritzen, Jes Bruun and Rasmussen, Mette and Helander, Anders and Adami, Johanna and Tønnesen, Hanne}}, issn = {{1745-3682}}, language = {{eng}}, month = {{04}}, pages = {{424--431}}, publisher = {{Taylor & Francis}}, series = {{Acta Orthopaedica}}, title = {{Minor effect of patient education for alcohol cessation intervention on outcomes after acute fracture surgery: a randomized trial of 70 patients}}, url = {{http://dx.doi.org/10.2340/17453674.2022.2482}}, doi = {{10.2340/17453674.2022.2482}}, volume = {{93}}, year = {{2022}}, }