Postoperative morbidity among symptom-free alcohol misusers

H Tønnesen; K R Petersen; L Højgaard; K H Stokholm; H J Nielsen; U Knigge; H Kehlet

Postoperative morbidity among symptom-free alcohol misusers

H Tønnesen, K R Petersen, L Højgaard, K H Stokholm, H J Nielsen, U Knigge, H Kehlet

133 Citations (Scopus)

Abstract

Retrospective studies suggest that there is an increased postoperative morbidity among alcohol misusers. We have prospectively studied the risk of alcohol intake among patients undergoing surgery. We investigated 15 symptom-free subjects who required colorectal surgery and who were drinking at least 60 g of alcohol per day. These patients were matched for sex, nutrition, age, weight, cardiovascular and pulmonary disease, diagnosis, anaesthesia, and surgery to 15 control subjects who were consuming below 25 g of alcohol daily. Those drinking at least 60 g of alcohol per day developed more postoperative complications than controls (67% vs 20%, p less than 0.05) and hospital stay was prolonged (20 vs 12 days, p less than 0.05). Preoperatively, alcohol misusers had reduced left ventricular ejection fraction (median, 54% vs 68%, p less than 0.01). Delayed hypersensitivity responses were smaller in the alcohol group before (53 mm2 vs 78 mm2, p less than 0.05) and after (18 mm2 vs 55 mm2, p less than 0.01) surgery. Alcohol misusers had longer bleeding times during the first postoperative week (p less than 0.01). Surgical stress responses, as assessed by changes in plasma cortisol and catecholamines, were higher among alcoholics (p less than 0.05). Postoperative morbidity is increased in symptom-free alcohol misusers. The mechanism is probably subclinical cardiac insufficiency, immunosuppression, and decreased haemostatic function. Preoperative alcohol consumption may be a more important risk factor than previously thought.

Original language	English
Journal	Lancet Oncology
Volume	340
Issue number	8815
Pages (from-to)	334-7
Number of pages	4
ISSN	0140-6736
Publication status	Published - 8 Aug 1992

Keywords

Aged
Aged, 80 and over
Alcoholism
Bleeding Time
Blood Coagulation Disorders
Blood Glucose
Blood Pressure
Cardiac Output, Low
Catecholamines
Colonic Diseases
Denmark
Heart Rate
Hospitals, University
Humans
Hydrocortisone
Immunologic Deficiency Syndromes
Infection
Length of Stay
Male
Matched-Pair Analysis
Middle Aged
Nursing Care
Postoperative Complications
Prospective Studies
Rectal Diseases
Risk Factors
Stroke Volume
Journal Article
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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@article{3233cc61b65f48dcba60112c0d48b8de,

title = "Postoperative morbidity among symptom-free alcohol misusers",

abstract = "Retrospective studies suggest that there is an increased postoperative morbidity among alcohol misusers. We have prospectively studied the risk of alcohol intake among patients undergoing surgery. We investigated 15 symptom-free subjects who required colorectal surgery and who were drinking at least 60 g of alcohol per day. These patients were matched for sex, nutrition, age, weight, cardiovascular and pulmonary disease, diagnosis, anaesthesia, and surgery to 15 control subjects who were consuming below 25 g of alcohol daily. Those drinking at least 60 g of alcohol per day developed more postoperative complications than controls (67% vs 20%, p less than 0.05) and hospital stay was prolonged (20 vs 12 days, p less than 0.05). Preoperatively, alcohol misusers had reduced left ventricular ejection fraction (median, 54% vs 68%, p less than 0.01). Delayed hypersensitivity responses were smaller in the alcohol group before (53 mm2 vs 78 mm2, p less than 0.05) and after (18 mm2 vs 55 mm2, p less than 0.01) surgery. Alcohol misusers had longer bleeding times during the first postoperative week (p less than 0.01). Surgical stress responses, as assessed by changes in plasma cortisol and catecholamines, were higher among alcoholics (p less than 0.05). Postoperative morbidity is increased in symptom-free alcohol misusers. The mechanism is probably subclinical cardiac insufficiency, immunosuppression, and decreased haemostatic function. Preoperative alcohol consumption may be a more important risk factor than previously thought.",

keywords = "Aged, Aged, 80 and over, Alcoholism, Bleeding Time, Blood Coagulation Disorders, Blood Glucose, Blood Pressure, Cardiac Output, Low, Catecholamines, Colonic Diseases, Denmark, Heart Rate, Hospitals, University, Humans, Hydrocortisone, Immunologic Deficiency Syndromes, Infection, Length of Stay, Male, Matched-Pair Analysis, Middle Aged, Nursing Care, Postoperative Complications, Prospective Studies, Rectal Diseases, Risk Factors, Stroke Volume, Journal Article, Research Support, Non-U.S. Gov't",

author = "H T{\o}nnesen and Petersen, {K R} and L H{\o}jgaard and Stokholm, {K H} and Nielsen, {H J} and U Knigge and H Kehlet",

year = "1992",

month = aug,

day = "8",

language = "English",

volume = "340",

pages = "334--7",

journal = "Lancet Oncology",

issn = "0140-6736",

publisher = "TheLancet Publishing Group",

number = "8815",

}

TY - JOUR

T1 - Postoperative morbidity among symptom-free alcohol misusers

AU - Tønnesen, H

AU - Petersen, K R

AU - Højgaard, L

AU - Stokholm, K H

AU - Nielsen, H J

AU - Knigge, U

AU - Kehlet, H

PY - 1992/8/8

Y1 - 1992/8/8

N2 - Retrospective studies suggest that there is an increased postoperative morbidity among alcohol misusers. We have prospectively studied the risk of alcohol intake among patients undergoing surgery. We investigated 15 symptom-free subjects who required colorectal surgery and who were drinking at least 60 g of alcohol per day. These patients were matched for sex, nutrition, age, weight, cardiovascular and pulmonary disease, diagnosis, anaesthesia, and surgery to 15 control subjects who were consuming below 25 g of alcohol daily. Those drinking at least 60 g of alcohol per day developed more postoperative complications than controls (67% vs 20%, p less than 0.05) and hospital stay was prolonged (20 vs 12 days, p less than 0.05). Preoperatively, alcohol misusers had reduced left ventricular ejection fraction (median, 54% vs 68%, p less than 0.01). Delayed hypersensitivity responses were smaller in the alcohol group before (53 mm2 vs 78 mm2, p less than 0.05) and after (18 mm2 vs 55 mm2, p less than 0.01) surgery. Alcohol misusers had longer bleeding times during the first postoperative week (p less than 0.01). Surgical stress responses, as assessed by changes in plasma cortisol and catecholamines, were higher among alcoholics (p less than 0.05). Postoperative morbidity is increased in symptom-free alcohol misusers. The mechanism is probably subclinical cardiac insufficiency, immunosuppression, and decreased haemostatic function. Preoperative alcohol consumption may be a more important risk factor than previously thought.

AB - Retrospective studies suggest that there is an increased postoperative morbidity among alcohol misusers. We have prospectively studied the risk of alcohol intake among patients undergoing surgery. We investigated 15 symptom-free subjects who required colorectal surgery and who were drinking at least 60 g of alcohol per day. These patients were matched for sex, nutrition, age, weight, cardiovascular and pulmonary disease, diagnosis, anaesthesia, and surgery to 15 control subjects who were consuming below 25 g of alcohol daily. Those drinking at least 60 g of alcohol per day developed more postoperative complications than controls (67% vs 20%, p less than 0.05) and hospital stay was prolonged (20 vs 12 days, p less than 0.05). Preoperatively, alcohol misusers had reduced left ventricular ejection fraction (median, 54% vs 68%, p less than 0.01). Delayed hypersensitivity responses were smaller in the alcohol group before (53 mm2 vs 78 mm2, p less than 0.05) and after (18 mm2 vs 55 mm2, p less than 0.01) surgery. Alcohol misusers had longer bleeding times during the first postoperative week (p less than 0.01). Surgical stress responses, as assessed by changes in plasma cortisol and catecholamines, were higher among alcoholics (p less than 0.05). Postoperative morbidity is increased in symptom-free alcohol misusers. The mechanism is probably subclinical cardiac insufficiency, immunosuppression, and decreased haemostatic function. Preoperative alcohol consumption may be a more important risk factor than previously thought.

KW - Aged

KW - Aged, 80 and over

KW - Alcoholism

KW - Bleeding Time

KW - Blood Coagulation Disorders

KW - Blood Glucose

KW - Blood Pressure

KW - Cardiac Output, Low

KW - Catecholamines

KW - Colonic Diseases

KW - Denmark

KW - Heart Rate

KW - Hospitals, University

KW - Humans

KW - Hydrocortisone

KW - Immunologic Deficiency Syndromes

KW - Infection

KW - Length of Stay

KW - Male

KW - Matched-Pair Analysis

KW - Middle Aged

KW - Nursing Care

KW - Postoperative Complications

KW - Prospective Studies

KW - Rectal Diseases

KW - Risk Factors

KW - Stroke Volume

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

M3 - Journal article

C2 - 1353805

SN - 0140-6736

VL - 340

SP - 334

EP - 337

JO - Lancet Oncology

JF - Lancet Oncology

IS - 8815

ER -

Postoperative morbidity among symptom-free alcohol misusers

Abstract

Keywords

UN SDGs

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