Perioperative alcohol cessation intervention reduces postoperative complications

Perioperative alcohol cessation intervention reduces postoperative complications

Brian McAvoy
PEARLS No.
637
Clinical question

How effective is perioperative alcohol cessation intervention in reducing postoperative complications and alcohol consumption?

Bottom line

Intensive alcohol cessation interventions in the perioperative period reduced postoperative complications (eg, wound‐related complications, secondary surgery, cardiopulmonary complications, admission to intensive care) as defined by the need for treatment (moderate-quality evidence). Intensive alcohol cessation interventions increased successful quitting (number of abstainers) at the end of the programme (moderate-quality evidence). There was insufficient evidence to determine if there were any differences in effect of intervention on mortality, length of hospital stay or postoperative alcohol consumption (grams of alcohol per week). Participants were identified as those with “risky drinking” – alcohol consumption equivalent to more than 3 alcoholic units per day or 21AU per week (1AU = 12g ethanol) with or without symptoms of alcohol abuse or dependency.

Caveat

All 3 studies were small (total of 140 participants) and conducted in Denmark, and most participants were men. None of the included studies evaluated the prevalence of participants who continued to avoid risky drinking in the longer term (3, 6, 9 and 12‐month follow‐up).

Context

Risky consumption of alcohol is a global problem. More than 3.3 million deaths annually are associated with risky use of alcohol, and global alcohol consumption continues to increase. People who have high alcohol consumption often require planned and emergency surgical procedures. Risky drinking is associated with increased postoperative complications, such as infections, cardiopulmonary complications and bleeding episodes.

Cochrane Systematic Review

Egholm JWM et al. Perioperative alcohol cessation interventions for postoperative complications. Cochrane Reviews, 2018, Issue 11. Art. No.: CD008343.DOI: 10.1002/14651858. CD008343.pub3. This review contains 3 studies involving 140 participants.