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Erschienen in:
01.11.2010 | 2010 SSAT Plenary Presentation
Alcohol Exposure as a Risk Factor for Adverse Outcomes in Elective Surgery
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 11/2010
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Background and Aims
Alcohol consumption is a well-documented determinant of adverse perioperative outcome. We sought to determine the effect of active alcohol consumption following elective surgery.
Methods
We queried discharge records from the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP, 2005–2007) for all elective adult admissions. The 7,631 (2.5%) patients with documented alcohol use (active alcohol use of at least two drinks per day within 2 weeks of surgery; ETOH use) underwent elective surgery; 301,994 (97.5%) patients denied ETOH use. Multivariate analysis was performed with adjustments for demographic and comorbid factors. Primary outcome measures included length of stay (LOS), postoperative complications, and death.
Results
ETOH use associated with elective surgery decreased over the course of the study (p < 0.0001). ETOH use was an independent predictor of pneumonia (OR 1.98, 95% CI 1.84–2.13), sepsis (OR 1.19, 95% CI 1.03–1.37), superficial surgical site infection (SSI; OR 1.15, 95% CI 1.02–1.31), wound disruption (OR 1.41, 95% CI 1.11–1.80), and prolonged LOS (OR 1.17, 95% CI 1.08–1.26). Except for SSI, these complications were independent risk factors for postoperative mortality. ETOH use was associated with earlier time to wound disruption (9 vs. 11 days; p = 0.04), longer median hospital stays (5 vs. 3 days; p < 0.0001), and longer LOS after operation (4 vs. 3 days; p < 0.0001).
Conclusions
Active alcohol consumption is a significant determinant of adverse outcomes in elective surgery; patients with ETOH use who are scheduled to undergo elective surgery should be appropriately educated and counseled.