July 23, 2008

Pre-Surgery Alcohol Abuse Not Detected

Alcohol use disorders are often overlooked in patients undergoing surgery although alcohol use can increase complication risk, German researchers said.

Anesthesiologist Dr. Claudia D. Spies and her research group at Charite-Universitaetsmedizin Berlin studied 1,556 surgical patients and found a trend of missed opportunities in identifying those at risk.

First, we noted that alcohol use disorders is not diagnosed adequately during preoperative assessment, Spies said in a statement. Then, even if a finding of alcohol use disorders was made before surgery, preventive measures were not often undertaken. This is significant because patients with alcohol use disorders have three to four times more complications during and around the time of surgery than patients without alcohol use disorders.

However, Spies said a computerized self-assessment tool, the Alcohol Use Disorder Identification Test, or AUDIT, can result in more than twice as many patients with alcohol use disorders being identified compared to the standard preoperative interview.

Part of AUDIT's success -- when compared to physicians' interviews alone -- may be due in part to physicians' lack of training in preoperative screening for alcohol use and also the more anonymous nature of the computerized test itself, Spies said.

The findings are published in the journal Anesthesiology.