Alcohol screening questionnaire can help identify high-risk drinkers with increased postoperative health care use
Alcohol misuse is a potentially modifiable risk factor for postoperative complications. The commonly used three-item AUDIT-C alcohol screening questionnaire could be used to identify patients at increased risk for costly postoperative inpatient health care use, concludes a new study. Providing these patients with preoperative alcohol interventions might provide a cost-effective approach to decrease postoperative resource use as well as improve patient outcomes, suggest the researchers.
The study included male Veterans Affairs patients who completed the AUDIT-C on mailed surveys from October 2003 through September 2006, who were hospitalized for nonemergency, noncardiac major operations in the following year. The researchers evaluated postoperative inpatient health care use across four AUDIT-C risk groups (scores 0, 1 to 4, 5 to 8, and 9 to 12), adjusting for smoking status, sociodemographics, and other factors.
Patients with high-risk drinking (AUDIT-C scores 9 to 12) spent nearly a day longer in the hospital and had longer intensive care unit stays after surgery compared with low-risk drinkers (AUDIT-C scores 1 to 4), and were twice as likely to return to the operating room. High-risk drinking was not associated with hospital readmission. Lower level at-risk drinking (AUDIT-C scores 5 to 8) was not associated with any measure of postoperative health care use. Nondrinkers (AUDIT-C score 0) had increased health care use on all measures compared with low-risk drinkers, but the differences were relatively small. This study was supported in part by the Agency for Healthcare Research and Quality (T32 HS13853).
See "AUDIT-C alcohol screening results and postoperative inpatient health care use" by Anna D. Rubinsky, MS, Haili Sun, PhD, David K. Blough, PhD, and others in the Journal of the American College of Surgeons 214, pp. 296-395, 2012.