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
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
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
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,"
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,
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