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.




Read Health24’s Comments Policy

Comment on this story
Comments have been closed for this article.

Live healthier

Teen angst »

Detecting depression: Phone apps could monitor teen angst

Studies have linked heavy smartphone use with worsening teen mental health. But as teens scroll through Instagram and Snapchat, tap out texts or watch YouTube videos, they also leave digital footprints that might offer clues to their psychological well-being.

Lifestyle changes »

Lifestyle changes helped new dad shed more than 20kg

Erik Minaya started to put on the kilos during his first year year in college. By age 24, he tipped the scale at nearly 120kg. But then he cut out fast food, replacing it with lower-carb offerings that he prepared himself.