The authors have no funding, financial relationships, or conflicts of interest to disclose.
Head and Neck
The effect of alcohol abuse and alcohol withdrawal on short-term outcomes and cost of care after head and neck cancer surgery†
Version of Record online: 7 MAY 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 8, pages 1739–1747, August 2012
How to Cite
Genther, D. J. and Gourin, C. G. (2012), The effect of alcohol abuse and alcohol withdrawal on short-term outcomes and cost of care after head and neck cancer surgery. The Laryngoscope, 122: 1739–1747. doi: 10.1002/lary.23348
- Issue online: 25 JUL 2012
- Version of Record online: 7 MAY 2012
- Accepted manuscript online: 11 APR 2012 02:21PM EST
- Manuscript Accepted: 19 MAR 2012
- Manuscript Revised: 26 FEB 2012
- Manuscript Received: 12 JAN 2012
- Alcohol abuse;
- alcohol withdrawal;
- head and neck neoplasms;
- Nationwide Inpatient Sample;
- Level of Evidence: 2c
Alcohol abuse is associated with an increased incidence of postoperative complications in surgical patients and is a significant risk factor for the development of head and neck cancer (HNCA). We sought to determine the relationship between alcohol abuse and in-hospital mortality, postoperative complications, length of stay, and costs in HNCA surgery.
Retrospective cross-sectional study.
Discharge data from the Nationwide Inpatient Sample for 92,312 patients aged 18 years and older who underwent an ablative procedure for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2003 to 2008, were analyzed using cross-tabulations and multivariate regression modeling.
Patients who abused alcohol were more likely to have advanced comorbidity, undergo major surgical procedures, and require medical care at another facility or home healthcare after discharge. The development of alcohol withdrawal symptoms (AWS) was associated with an increased incidence of acute medical complications (odds ratio [OR]: 5.6, P < .001) and surgical complications (OR: 2.3, P < .001). After controlling for all other variables, there was no significant association of alcohol abuse or AWS with in-hospital mortality; however, alcohol abuse and AWS were associated with significantly increased length of hospitalization and hospital-related costs, with AWS having the single largest impact on length of stay and costs.
Alcohol withdrawal is associated with an increase in postoperative medical and surgical complications, length of hospitalization, and hospital-related costs in HNCA surgical patients. Aggressive measures to prevent the development of AWS in patients who abuse alcohol are warranted. Laryngoscope, 2012