Preoperative alcoholism and postoperative morbidity

Background: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. Methods: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity in alco...

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Bibliographic Details
Published in:British journal of surgery 1999-07, Vol.86 (7), p.869-874
Main Authors: Tønnesen, H., Kehlet, H.
Format: Article
Language:English
Subjects:
Addictive behaviors
Adult and adolescent clinical studies
Alcoholism
Alcoholism - complications
Biological and medical sciences
Cardiomyopathy, Alcoholic - etiology
Hemostasis, Surgical
Humans
Immunologic Deficiency Syndromes - etiology
Medical sciences
Miscellaneous
Postoperative Complications - etiology
Preoperative Care
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Stress, Psychological - etiology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Wound Healing - physiology
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Summary:Background: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. Methods: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity in alcohol abusers were used to evaluate the evidence. Results: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications account for about half of the morbidity. The pathogenic mechanisms include preoperative immune incompetence, subclinical cardiac insufficiency and haemostatic imbalance. In addition, surgical trauma and/or postoperative abstinence result in an exaggerated stress response, which may further contribute to postoperative morbidity. Conclusion: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration to avoid the abstinence response. © 1999 British Journal of Surgery Society Ltd
ISSN:0007-1323
1365-2168
DOI:10.1046/j.1365-2168.1999.01181.x