28 June 2013

Alcohol and surgery a bad combination

People who have more than a couple of alcoholic drinks every day tend to have more complications after surgery than teetotallers or light drinkers.


People who have more than a couple of alcoholic drinks every day tend to have more complications after surgery than teetotallers or light drinkers, according to a review of past studies.

The analysis confirms that "alcohol and surgery are a bad combination", said Bolette Pedersen of the Clinical Health Promotion Centre of Bispebjerg and Frederiksberg University Hospital in Denmark.

But it's not clear what effect stopping drinking before surgery would have on complications, said Pedersen, who was not involved in the review.

Infections and slow wound healing were the most common complications associated with heavy drinking, according to lead author Marie Eliasen of the National Institute of Public Health at the University of Southern Denmark in Copenhagen.

Eliasen and her co-authors examined the results of 55 studies on pre-op drinking and post-op complications occurring up to 30 days after surgery. The studies looked at head and neck, abdominal and orthopaedic surgeries for a variety of conditions, none of which was related to alcohol use.

Patients who drank heavily leading up to surgery, including those who abused alcohol or were dependent on it, were more than twice as likely to die in the month after their procedures than abstainers – though the risk of dying varied greatly by procedure.

Heavy drinkers were also 73% more likely to contract a post-op infection, 80% more likely to have difficulty breathing and 29% more likely to be admitted to the intensive care unit than non-drinkers, according to results published in the Annals of Surgery.

Alcohol compromises immunity

The associations were stronger with abdominal surgery - which can include gallbladder, liver and stomach procedures - than with other types of operations.

Low to moderate drinking – a drink or two per day or less – was not tied to post-op complications, but only a few studies addressed that group, Eliasen said.

Heavy alcohol use over time compromises the immune system, which makes the body more susceptible to infections, she said.

"Moreover, high alcohol consumption increases the endocrine stress response to surgery which may worsen existing conditions and reduces blood coagulation, giving an increased risk of bleedings and slowing down wound healing processes," she said.

The studies looked at alcohol consumption over different lengths of time, from months to years, so it's unclear what duration of alcohol use leads to higher risks or when a patient's drinking has the strongest effects. But it's likely that the more you drink, the quicker the extra risks would appear, Eliasen said.

A previous study found that post-op risks declined when patients stopped drinking four or more weeks before surgery, she said.

Though it may seem like common sense, sometimes doctors don't advise their patients to stop drinking before an operation, she added.

Few patients are offered specific 'stop-drinking' programmes as part of the lead up to surgery, Pedersen said.

It's much more common that patients are encouraged to stop smoking.

"In my opinion, it is now time to focus on intervention studies (randomised trials) to evaluate the effects of 'stop-drinking' in relation to surgery," she said.





Get a quote


Read Health24’s Comments Policy

Comment on this story
Add your comment
Comment 0 characters remaining

Live healthier

Hit the road »

Advice for the long runner Hill training: how to do it Why running is good for you

What to wear when you run

You do not need a gym membership to run. All you need is the correct clothing and you're ready to reap the benefits.

Carb danger »

Why we get fat Why you need to worry about fructose Craving sugar? Blame your brain

Carbs make you sick

Dr Gary Fettke, who believes that the foods we eat are the leading cause of lifestyle diseases speaks of Carbohydrate Diabetes, not Sugar Diabetes.