Probable alcohol abuse or dependence: A risk factor for intensive-care readmission in patients undergoing elective vascular and thoracic surgical procedures

Objective: To determine whether alcohol abuse or dependence is a risk facto r for perioperative complications, increased duration of hospital stay, and increased utilization of nursing resources in patients undergoing thoracic and vascular surgical procedures. Material and Methods: We conducted a prospective study of all adult patient s who underwent an elective vascular or thoracic surgical procedure and who received postoperative care in an intensive-care setting. Patients were sc reened for alcohol abuse or dependence, and actual versus expected duration s of stay were evaluated. The patients' medical records were reviewed for p reoperative comorbidities and perioperative complications. Fisher's exact t est and the rank sum test were used in the analyses, Results: Of 321 study subjects, 290 were classified as nonalcoholic and 31 as probable alcoholic patients, Patients in the probable alcohol abuse grou p had a significantly increased rate of alcohol withdrawal (12.9% versus 1. 7%; P = 0.006) in comparison with patients in the nonalcoholic group. Patie nts in the probable alcohol abuse group were readmitted to an intensive-car e unit more frequently (19.4% versus 7.9%; P = 0.047) and required sedation more often (32.3% versus 13.5%; P = 0.014) than those in the nonalcoholic group. No significant differences were found between the two study groups i n intensive-care unit and hospital durations of stay or in utilization of: nursing resources. A dismissal diagnosis of alcoholism was recorded for onl y one of four patients who had a documented withdrawal episode among those categorized in the probable alcoholic group and for three of five patients with alcohol withdrawal symptoms categorized in the nonalcoholic group. Conclusion: Except for the occurrence of alcohol withdrawal syndrome, study patients classified in the probable alcohol abuse group did not have more medical or surgical perioperative complications than patients in the nonalc oholic group. They did have significantly more intensive-rare setting readm issions, Patients with documented alcohol withdrawal episodes frequently we re dismissed without a diagnosis of substance abuse or dependence.