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

Rubinsky AD, Bishop MJ, Maynard C, Henderson WG, Hawn MT, Harris AH, Beste LA, Tønnesen H, Bradley KA. Postoperative risks associated with alcohol screening depend on documented drinking at the time of surgery. Drug and Alcohol Dependence. 2013 Oct 1; 132(3):521-7.

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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 > 2d/d") are associated with increased postoperative complications and health care utilization. The purpose of this study was to evaluate whether documented drinking > 2d/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 > 2d/d, with AUDIT-C scores 1-4 and no documented drinking > 2d/d as the referent, after adjusting for important covariates. RESULTS: Overall 8811 patients met inclusion criteria. Among patients with documented drinking > 2d/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 > 2d/d, increasing AUDIT-C scores were not associated with these outcomes. CONCLUSIONS: Clinical documentation of drinking > 2d/d immediately prior to surgery contributed additional information about postoperative risk beyond past-year AUDIT-C score. However, among patients with documented drinking > 2d/d, postoperative risk varied widely depending on the AUDIT-C score.