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Minor effect of patient education for alcohol cessation intervention on outcomes after acute fracture surgery: a randomized trial of 70 patients

Weber Melchior Egholm, Julie ; Pedersen, Bolette LU ; Oppedal, Kristian ; Madsen, Bjørn Lindegård ; Lauritzen, Jes Bruun ; Rasmussen, Mette LU orcid ; Helander, Anders ; Adami, Johanna and Tønnesen, Hanne LU (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)
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author
; ; ; ; ; ; ; and
organization
publishing date
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}},
}