Alcoholics at risk of infection after heart surgery

NEW YORK (Reuters Health) – Patients with long-standing
alcoholism who undergo heart surgery are four times more likely
to acquire an infection after the operation than their
non-alcoholic peers, according to a new report. The results
suggest that the elevated risk may be associated with increased
levels of two immune factors — interleukin-10, an
anti-inflammation protein, and cortisol, a steroid hormone.

“A key consideration here is that long-term alcoholics have
pretty well-defined immune alterations prior to clinically
evident infections,” lead author Dr. Michael Sander, from
University Hospital Charite in Berlin, said in a statement.

“We believe that these alterations might be responsible for
the postoperative increased infection rate observed in our
study and in others,” Sander added.

The new study, which is reported in the September issue of
Alcoholism: Clinical & Experimental Research, involved a
comparison of 10 alcoholics who underwent elective cardiac
surgery with 34 non-alcoholic patients.

Blood samples were obtained at several points before and
after surgery to assess levels of IL-10, cortisol, and other
immune factors, the report indicates.

As noted, compared with the non-alcoholic group, the
alcoholic group was at heightened risk for postoperative
infections. In addition, alcoholic patients had longer
intensive care unit (ICU) stays and were slower to wean off
mechanical ventilation.

Moreover, the alcoholic group also displayed increased
levels of IL-10 and cortisol postoperatively. In fact, elevated
IL-10 levels were predictive of postoperative infections, the
report indicates.

Sander and colleagues think it’s worth investigating
whether treatments that modulate the immune system given before
and during surgery may help decrease the infection rate as well
as the lengthy ICU stay among alcoholic patients undergoing
heart surgery.

SOURCE: Alcoholism: Clinical and Experimental Research,
September 2005.