Original CommunicationPrevalence of alcohol misuse among men and women undergoing major noncardiac surgery in the Veterans Affairs health care system
Section snippets
Data sources
This study used quality improvement and administrative data from 4 sources as described below.
Results
A total of 287,060 Veterans were eligible for inclusion in VASQIP during the study. Of these, 10,284 patients (9,771 men and 513 women) had an operation assessed by VASQIP, were sampled randomly for the SHEP survey, and completed the alcohol screening questions (AUDIT-C) on SHEP in the year before the operation, making them eligible for this study. Demographic characteristics and preoperative clinical characteristics of the study sample are shown in Table II. Patient ages ranged from 21 to ≥90
Discussion
Sixteen percent of men and 5% of women in this national sample of VA patients undergoing surgery screened positive for alcohol misuse on the AUDIT-C at levels associated with increased postoperative complications.15 In men, the prevalence of alcohol misuse exceeded 10% in all subgroups evaluated except 2: men >70 years of age and men with renal disease. More than a quarter of men who smoked cigarettes screened positive for alcohol misuse, although the prevalence of alcohol misuse was less among
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Cited by (27)
Preoperative alcohol interventions for elective surgical patients: Results from a randomized pilot trial
2022, Surgery (United States)Citation Excerpt :Participants were eligible for the trial if they met all inclusion criteria and scored ≥5 on the AUDIT-C for past 3 months alcohol use, assessed by research staff. A score of ≥5 before surgery is associated with adverse surgical outcomes.3,25,26 Exclusion screening criteria included: (1) inability to provide voluntary informed consent for any reason (including incompetency); (2) substantial cognitive impairment as evidenced by lack of orientation to person, place, or time or lack of ability to repeat back and answer screening questions; (3) evidence of psychotic symptoms; (4) inability to read or understand English; (5) undergoing surgeries/procedures that require local anesthesia only.
The Potential of Prehabilitation in Radical Cystectomy Pathways: Where Are We Now?
2021, Seminars in Oncology NursingCitation Excerpt :Risky drinking affects immune capacity, cardiac function, and in addition risky drinking increases the endocrine stress response to surgery, leading to deterioration of existing conditions, which thus increases the risk of postoperative morbidity. The threshold for an increased risk of complications may be as low as >2 drinks per day85 and, because these patients often are relatively healthy, staff may not be alerted to their risky alcohol intake at admission to surgery.86 In patients undergoing radical cystectomy preoperative, alcohol consumption is associated with increased risk of developing postoperative complications.87
Cognitive impairment assessment and interventions to optimize surgical patient outcomes
2020, Best Practice and Research: Clinical AnaesthesiologyCitation Excerpt :Alcohol abuse is the third leading preventable cause of mortality in the United States, leading to the loss of more than 88 000 lives annually (2.5 million years of life lost) [123]. Alcohol use is also a modifiable risk factor for perioperative complications, especially when the consumption exceeds >60 g of alcohol per day [124]. Screening for alcohol use during the preoperative evaluation should help identify those patients who are at risk of developing alcohol withdrawal.
National prevalence and correlates of alcohol misuse in women veterans
2015, Journal of Substance Abuse TreatmentCitation Excerpt :Alcohol misuse, defined as drinking above recommended limits, is a health concern in military and veteran populations (IOM (Institute of Medicine), 2012; Office of Applied Studies, 2005). Although most research on alcohol misuse in U.S. veterans has focused on men, a number of recent studies have highlighted it as a health issue for women veterans (Bradley et al., 2012; Calhoun, Elter, Jones, Kudler, & Straits-Troster, 2008; Chavez, Williams, Lapham, & Bradley, 2012; Denneson, Lasarev, Dickinson, & Dobscha, 2011; Eisen et al., 2012; Grossbard et al., 2013; Grossbard, Hawkins, et al., 2013; Harris, Bradley, Bowe, Henderson, & Moos, 2010; Hawkins, Lapham, Kivlahan, & Bradley, 2010; Hoggatt et al., 2015; Williams et al., 2014). This research attention comes at a time when women's roles in the military are expanding, and their representation in the veteran population is rapidly increasing.
A group-based brief intervention for surgery patients with high-risk substance use
2014, General Hospital PsychiatryCitation Excerpt :Clear data on prevalence rates of substance use among preoperative patients are difficult to obtain due to variability in reporting rates and testing procedures. However, a recent study by Bradley and colleagues [1] reported the prevalence of alcohol misuse to be 16% among men and 5% among women undergoing noncardiac surgical procedures in the Veterans Affairs health care system. Excessive or high-risk use of alcohol has been established as a primary risk factor for adverse outcomes during and following surgery [2–6].
Postoperative risks associated with alcohol screening depend on documented drinking at the time of surgery
2013, Drug and Alcohol DependenceCitation Excerpt :Alcohol misuse, which includes a spectrum of severity ranging from drinking above recommended limits to diagnosis of alcohol dependence, is common among general surgical patients (13–29%; Agabio et al., 2012; Bradley et al., 2012; Neumann et al., 2012; Shourie et al., 2007) and a risk factor for postoperative complications and increased postoperative health care utilization (Bradley et al., 2011; Delgado-Rodriguez et al., 2003; Harris et al., 2008, 2011; Nath et al., 2010; Rubinsky et al., 2012; Spies et al., 2001, 2004; Tonnesen, 1999; Tonnesen et al., 2009).
Supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development and Health Services Research and Development (HSR&D; project IAC 06-021). Dr Bradley was an investigator at the Veterans Affairs Northwest HSR&D Center of Excellence and at the Center of Excellence in Substance Abuse Treatment and Education, VA Puget Sound Health Care System, Seattle, WA, while this work was conducted.
This material is based upon work supported by the US Department of Veterans Affairs, Office of Research and Development. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.