Pre-operative screening for excessive alcohol consumption among patients scheduled for elective surgery

Authors

  • SWATI SHOURIE,

    1. School of Public Health, The University of Sydney, NSW, Australia
    Search for more papers by this author
    • 4

      Swati Shourie MDS, PhD student, School of Public Health, The University of Sydney, NSW 2006, Australia

  • KATHERINE M. CONIGRAVE,

    Corresponding author
    1. School of Public Health, The University of Sydney, NSW, Australia
    2. Drug Health Services, Royal Prince Alfred Hospital, Camperdown NSW, Australia
    Search for more papers by this author
    • 5

      Katherine M. Conigrave FAChAM, FAFPHM, PhD, Staff Specialist, Drug Health Services, Royal Prince Alfred Hospital, Camperdown NSW 2050 and Associate Professor of Medicine, Psychological Medicine and Public Health, The University of Sydney, NSW 2006, Australia

  • ELIZABETH M. PROUDE,

    1. Drug Health Services, Royal Prince Alfred Hospital, Camperdown NSW, Australia
    Search for more papers by this author
    • 6

      Elizabeth M. Proude MA, PhD, Research Fellow, Drug Health Services, Royal Prince Alfred Hospital, Camperdown NSW 2050, Australia

  • JEANETTE E. WARD,

    1. Division of Population Health, South West Sydney Area Health Services, Sydney, Australia
    Search for more papers by this author
    • 7

      Jeanette E. Ward MBBS MHPEd, PhD, FAFPHM, Area Director, Division of Population Health, South West Sydney Area Health Services and Conjoint Professor, School of Public Health, The University of Sydney, NSW 2006, Australia

  • SONIA E. WUTZKE,

    1. School of Public Health, The University of Sydney, NSW, Australia
    Search for more papers by this author
    • 8

      Sonia E. Wutzke BSc (Psych) Hons, MPH, PhD, Honorary Associate, School of Public Health, The University of Sydney, NSW 2006, Australia

  • PAUL S. HABER

    1. School of Public Health, The University of Sydney, NSW, Australia
    2. Drug Health Services, Royal Prince Alfred Hospital, Camperdown NSW, Australia
    Search for more papers by this author
    • 9

      Paul S. Haber MD, FRACP, FAChAM, Director, Drug Health Services, Royal Prince Alfred Hospital, Camperdown NSW 2050 and Associate Professor of Medicine and Public Health, The University of Sydney, NSW 2006, Australia.


Drug Health Services, Level 5, Page Building, Missenden Road, Royal Prince Alfred Hospital, Camperdown NSW 2050, Australia. Tel: +61 2 9515 8650; Fax: +61 2 9515 8970; E-mail: katec@med.usyd.edu.au

Abstract

Pre-operative intervention for excessive alcohol consumption among patients scheduled for elective surgery has been shown to reduce complications of surgery. However, successful intervention depends upon an effective and practical screening procedure. This study examines current screening practices for excessive alcohol consumption amongst patients scheduled for elective surgery in general hospitals. It also examines the appropriateness of potential sites and staff for pre-operative screening. Forms used routinely to assess alcohol consumption in the pre-admission clinics (PAC) of eight Sydney hospitals were examined. In addition, the appropriateness of six staff categories (surgeons, surgeons' secretaries, junior medical officer, anaesthetists, nurses and a research assistant) and of two sites (surgeons' office and PAC) in conducting additional screening was assessed at two hospitals. Outcomes included observed advantages and disadvantages of sites and personnel, and number of cases with excessive drinking identified. There was duplication in information collected routinely on alcohol use in the PACs in eight Sydney Hospitals. Questions on alcohol consumption in patient self-completion forms were not validated. The PAC provided for efficient screening but time to surgery was typically too short for successful intervention in many cases. A validated tool and efficient screening procedure is required to detect excessive drinking before elective surgery. Patients often present to the PAC too close to the time of surgery for any change in drinking to reverse alcohol's effects. The role of the referring general practitioner and of printed advice from the surgeon in preparing patients for surgery needs further investigation.

Ancillary