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Preoperative Alcohol Consumption and Postoperative Complications: A Systematic Review and Meta-Analysis

Eliasen, Marie MSc*; Grønkjær, Marie Bsc*; Skov-Ettrup, Lise Skrubbeltrang MSc*; Mikkelsen, Stine Schou MSc*; Becker, Ulrik MD, DMSc*,†; Tolstrup, Janne Schurmann PhD, DMSc*; Flensborg-Madsen, Trine PhD

doi: 10.1097/SLA.0b013e3182988d59
Meta-Analyses

Objective: To systematically review and summarize the evidence of the association between preoperative alcohol consumption and postoperative complications elaborated on complication type.

Background: Conclusions in studies on preoperative alcohol consumption and postoperative complications have been inconsistent.

Methods: A systematic review and meta-analysis based on a search in MEDLINE, EMBASE, CINAHL, and PsycINFO citations. Included were original studies of the association between preoperative alcohol consumption and postoperative complications occurring within 30 days of the operation. In total, 3676 studies were identified and reviewed for eligibility, and data were extracted. Forest plots and pooled relative risks (RRs), including 95% confidence intervals (CIs), were estimated for several complication types.

Results: Fifty-five studies provided data for estimates. Preoperative alcohol consumption was associated with an increased risk of various postoperative complications, including general morbidity (RR = 1.56; 95% CI: 1.31–1.87), general infections (RR = 1.73; 95% CI: 1.32–2.28), wound complications (RR = 1.23; 95% CI: 1.09–1.40), pulmonary complications (RR = 1.80; 95% CI: 1.30–2.49), prolonged stay at the hospital (RR = 1.24; 95% CI: 1.18–1.31), and admission to intensive care unit (RR = 1.29; 95% CI: 1.03–1.61). Clearly defined high alcohol consumption was associated with increased risk of postoperative mortality (RR = 2.68; 95% CI: 1.50–4.78). Low to moderate preoperative alcohol consumption and postoperative complications did not seem to be associated; however, very few studies were included in the analyses hereof.

Conclusions: Preoperative alcohol consumption was associated with an increased risk of general postoperative morbidity, general infections, wound complications, pulmonary complications, prolonged stay at the hospital, and admission to intensive care unit.

In this meta-analysis, we systematically summarized the current evidence of the association between high preoperative alcohol consumption and postoperative complications elaborated on complication type. We found an increased risk of several postoperative complications among patients with high alcohol consumption, implying a special focus on reducing alcohol consumption before operation.

*National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark

Department of Medical Gastroenterology, Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark

Unit of Medical Psychology, Department of Public Health, University of Copenhagen, Denmark.

Reprints: Marie Eliasen, MSc, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, DK-1353, Copenhagen K, Denmark. E-mail: mae@niph.dk.

Disclosure: The Danish Health and Medicines Authority and the National Institute of Public Health, University of Southern Denmark funded this work. The Danish Health and Medicines Authority attributed to the development of the search strategy and with feedback in the preliminary phase but had no additional role in the design, conduct, or reporting of the review and meta-analysis, neither did the National Institute of Public Health, University of Southern Denmark. The authors declare no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins.