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Published on: January 29, 2017
Postoperative morbidity among symptom-free alcohol misusers
H Tønnesen1, K R Petersen, L Højgaard
1Department of Surgical Gastroenterology, Hvidovre Hospital, University of Copenhagen.
Lancet (London, England)
|August 8, 1992
Summary
Heavy alcohol consumption significantly increases postoperative complications and hospital stay in patients undergoing surgery. This risk is linked to subclinical cardiac issues, weakened immunity, and impaired blood clotting in individuals with alcohol use disorder.
Area of Science:
- Surgical Outcomes
- Alcohol-Related Health Issues
- Cardiovascular Physiology
Background:
- Previous studies indicate higher postoperative morbidity in alcohol misusers.
- The precise risks associated with preoperative alcohol intake require further prospective investigation.
Purpose of the Study:
- To prospectively assess the surgical risk associated with daily alcohol consumption.
- To identify physiological mechanisms linking alcohol use to postoperative complications.
Main Methods:
- A prospective study matched 15 alcohol misusers (≥60g/day) with 15 controls (<25g/day) undergoing colorectal surgery.
- Assessed postoperative complications, hospital stay, left ventricular ejection fraction, delayed hypersensitivity, bleeding times, and stress hormone levels.
Main Results:
- Alcohol misusers experienced significantly more complications (67% vs 20%) and longer hospital stays (20 vs 12 days).
- Preoperative findings included reduced left ventricular ejection fraction, smaller delayed hypersensitivity responses, and longer bleeding times in the alcohol group.
- Elevated surgical stress responses (cortisol, catecholamines) were observed in alcohol misusers.
Conclusions:
- Symptom-free alcohol misusers face increased postoperative morbidity.
- Mechanisms likely involve subclinical cardiac insufficiency, immunosuppression, and compromised hemostasis.
- Preoperative alcohol consumption is a significant, underestimated surgical risk factor.
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