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    Despite Possible Complications, Alcohol Use Disorders Often Undetected Before Surgery

    By Jennifer Huddleston, staff writer    

    A research group from Charite-Universitaetsmedizin Berlin led by anesthesiologist Claudia D. Spies, M.D. studied 1,556 surgical patients and found that alcohol use disorders (AUDs) are often overlooked in patients undergoing surgery. [1]

    This finding is alarming given the fact that “patients with AUD[s] have three to four times more complications during and around the time of surgery than patients without AUD[s],” according to lead researcher Spies.
    [2] Identifying and treating AUDs before surgery may improve surgical outcomes. [3]

    Further, previous research has shown that surgical patients with AUDs have longer stays in intensive care units and hospitals compared to patients without AUDs. Patients with AUDs also require special attention during surgery and being aware of patients’ AUDs enables physicians to anticipate increased anesthesia requirements and elevated responses to surgical stress.
    [4]

    The study’s findings, published in the August 2008 issue of Anesthesiology, revealed that doctors did not use well-documented tools for detecting AUDs.
    [5] Preoperative assessments should include evaluating patients in order to determine if they have an AUD, then identifying the type of AUD and initiating treatment. [6]

    Spies’ study found that when a computerized self-assessment tool called AUDIT (Alcohol Use Disorder Identification Test) was utilized, more than twice as many patients with AUDs were identified compared to when physicians conducted standard preoperative interviews. This finding may be attributed to the fact that patients prefer the anonymity of a computerized self-test and that many physicians lack training in preoperative screening for AUDs.
    [7]

    “Physicians tend to underestimate and miss AUD[s] in younger patients, especially young female patients,” said Spies. “Patients seem to be more confident in answering questions about their alcohol use in a computer-based question-and-answer format,” Spies said.
    [8] Spies’ research is the first to systematically study the effectiveness of a computerized version of the AUDIT test in a preoperative assessment clinic. [9]

    When an AUD is properly identified, physicians can then utilize intervention strategies such as tailored advice or a brief motivational interview.
    [10] Other preoperative interventions for at-risk alcohol drinkers include encouragement of abstinence and referrals for substance abuse counseling. The best way to reduce or eliminate perioperative complications due to AUDs is by abstaining from alcohol prior to surgery. [11]

    Requiring surgery can be a significant motivator for patients with AUDs to change their drinking habits and the time period before surgery is a favorable time to inspire patients to alter their drinking behaviors. Multiple interactions with physicians prior to surgery may also increase patients’ motivation to seek treatment for their AUDs. [12]



    [1] “Study Uncovers Sobering Facts About Alcohol Abuse Detection in Surgical Patients, Offers Simple Tool for Identifying Those at Risk.” Press Release, ASAHQ.org. July 23, 2008.
    [2]  Ibid.
    [3] Gordon, Adam J., Josh Olstein and Joseph Conigliaro. “Identification and Treatment of Alcohol Use Disorders in the Perioperative Period.” Postgraduate Medicine Online. Vol. 119, No. 2. July-August 2006.
    [4]  Ibid.
    [5]  “Study Uncovers Sobering Facts About Alcohol Abuse Detection in Surgical Patients, Offers Simple Tool for Identifying Those at Risk.” Press Release, ASAHQ.org. July 23, 2008.
    [6] Gordon, Adam J., Josh Olstein and Joseph Conigliaro. “Identification and Treatment of Alcohol Use Disorders in the Perioperative Period.” Postgraduate Medicine Online. Vol. 119, No. 2. July-August 2006.
    [7] Preidt, Robert. “Alcohol Use Frequently Overlooked Before Surgery.” Medline Plus. July 23, 2008.
    [8]  Ibid.
    [9] “Study Uncovers Sobering Facts About Alcohol Abuse Detection in Surgical Patients, Offers Simple Tool for Identifying Those at Risk.” Press Release, ASAHQ.org. July 23, 2008.
    [10]  Ibid.
    [11] Gordon, Adam J., Josh Olstein and Joseph Conigliaro. “Identification and Treatment of Alcohol Use Disorders in the Perioperative Period.” Postgraduate Medicine Online. Vol. 119, No. 2. July-August 2006.
    [12]  Ibid.



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