Preoperative alcoholism and postoperative morbidity
Article first published online: 10 DEC 2002
© 1999 British Journal of Surgery Society Ltd
British Journal of Surgery
Volume 86, Issue 7, pages 869–874, 1 July 1999
How to Cite
Tønnesen, H. and Kehlet, H. (1999), Preoperative alcoholism and postoperative morbidity. Br J Surg, 86: 869–874. doi: 10.1046/j.1365-2168.1999.01181.x
- Issue published online: 10 DEC 2002
- Article first published online: 10 DEC 2002
- Manuscript Accepted: 12 APR 1999
Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention.
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.
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.
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