Study Suggests Complications Following Total Joint Arthroplasty Significantly Related to Pre-Operative Alcohol Misuse among Veterans
The risks associated with pre-operative alcohol misuse in patients undergoing total joint arthroplasty are not well known, yet alcohol misuse is common in surgical patients and has been linked to an increased risk of post-operative complications in other procedures. This retrospective cohort study evaluated the association between a standardized, pre-operative alcohol screening score and the risk of post-operative complications in 185 Veterans who underwent total joint arthroplasty at one VA facility between 2004 and 2007. Investigators assessed AUDIT-C (Alcohol Use Disorders Identification Test – Consumption) scores, which had been recorded as part of routine clinical care in the 12 months preceding surgery, for Veterans who had reported at least some alcohol use. [Past-year non-drinkers were excluded from this study.]
Findings show that complications following total joint arthroplasty were significantly related to alcohol misuse. Of the 185 Veterans in this study, 32 (17%) had alcohol screening scores suggestive of alcohol misuse, and 12 Veterans had at least one post-operative complication. Therefore, AUDIT-C scores signified a 29% increase in the expected mean number of complications with every additional AUDIT-C point above 1.
The authors suggest that pre-operative alcohol misuse screening, and perhaps pre-operative counseling or referral to treatment for heavy drinkers, may be indicated for patients undergoing total joint arthroplasty.
Harris A, Reeder R, Ellerbe L, et al. Pre-operative alcohol screening scores: Association with complications in men undergoing total joint arthroplasty. Journal of Bone and Joint Surgery 2011 Feb;93(4):321-27.
Drs. Sox-Harris, Reeder, and Ellerbe are part of HSR&D’s Center for Health Care Evaluation in Palo Alto, CA.