Preoperative alcohol cessation prior to elective surgery

Area of Science:

• Surgery
• Addiction Medicine
• Public Health

Background:

• Hazardous alcohol consumption is linked to increased postoperative complications, including infections, cardiopulmonary issues, and bleeding.
• Preoperative abstinence may mitigate alcohol-induced physiological changes, potentially preventing surgical complications.

Purpose of the Study:

• To evaluate the impact of preoperative alcohol cessation interventions on postoperative complications and mortality in hazardous drinkers.
• To assess the long-term effects of these interventions on alcohol use post-surgery.

Main Methods:

• Systematic search of multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL) for randomized controlled trials (RCTs).
• Inclusion of RCTs assessing preoperative alcohol cessation interventions for hazardous drinkers, focusing on postoperative complications and alcohol consumption.
• Data extraction and analysis by three independent reviewers, with planned subgroup and sensitivity analyses.

Main Results:

• Two RCTs involving 69 patients were included, focusing on intensive alcohol cessation with pharmacological support.
• Meta-analysis indicated a significant reduction in overall postoperative complication rates (OR 0.22; P = 0.004).
• No significant reduction was observed in in-hospital or 30-day mortality (OR 0.39; P = 0.35), length of stay, or postoperative alcohol use.

Conclusions:

• Intensive preoperative alcohol cessation interventions, including pharmacological strategies, appear to significantly decrease postoperative complication rates.
• Further research is needed to explore the optimal timing, duration, and intensity of these interventions to improve surgical outcomes.
• Conducting such studies in surgical settings presents challenges due to a potentially high number needed to screen for eligible patients.