Probable alcohol abuse or dependence

A risk factor for intensive-care readmission in patients undergoing elective vascular and thoracic surgical procedures

Pamela M. Maxson, Karen L. Schultz, Keith H. Berge, Carla M. Lange, Darrell R. Schroeder, Teresa A. Rummans

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective: To determine whether alcohol abuse or dependence is a risk factor for perioperative complications, increased duration of hospital stay, and increased utilization of nursing resources in patients undergoing thoracic and vascular surgical procedures. Material and Methods: We conducted a prospective study of all adult patients who underwent an elective vascular or thoracic surgical procedure and who received postoperative care in an intensive-care setting. Patients were screened for alcohol abuse or dependence, and actual versus expected durations of stay were evaluated. The patients' medical records were reviewed for preoperative comorbidities and perioperative complications. Fisher's exact test and the rank sum test were used in the analyses. Results: Of 321 study subjects, 290 were classified as nonalcoholic and 31 as probable alcoholic patients. Patients in the probable alcohol abuse group had a significantly increased rate of alcohol withdrawal (12.9% versus 1.7%; P = 0.006) in comparison with patients in the nonalcoholic group. Patients in the probable alcohol abuse group were readmitted to an intensive-care unit more frequently (19.4% versus 7.9%; P = 0.047) and required sedation more often (32.3% versus 13.5%; P = 0.014) than those in the nonalcoholic group. No significant differences were found between the two study groups in intensive-care unit and hospital durations of stay or in utilization of nursing resources. A dismissal diagnosis of alcoholism was recorded for only one of four patients who had a documented withdrawal episode among those categorized in the probable alcoholic group and for three of five patients with alcohol withdrawal symptoms categorized in the nonalcoholic group. Conclusion: Except for the occurrence of alcohol withdrawal syndrome, study patients classified in the probable alcohol abuse group did not have more medical or surgical perioperative complications than patients in the nonalcoholic group. They did have significantly more intensive-care setting readmissions. Patients with documented alcohol withdrawal episodes frequently were dismissed without a diagnosis of substance abuse or dependence.

Original languageEnglish (US)
Pages (from-to)448-453
Number of pages6
JournalMayo Clinic Proceedings
Volume74
Issue number5
StatePublished - 1999
Externally publishedYes

Fingerprint

Thoracic Surgical Procedures
Vascular Surgical Procedures
Elective Surgical Procedures
Patient Readmission
Critical Care
Alcoholism
Alcohols
Substance-Related Disorders
Intensive Care Units
Length of Stay
Nursing
Substance Withdrawal Syndrome
Postoperative Care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Maxson, P. M., Schultz, K. L., Berge, K. H., Lange, C. M., Schroeder, D. R., & Rummans, T. A. (1999). Probable alcohol abuse or dependence: A risk factor for intensive-care readmission in patients undergoing elective vascular and thoracic surgical procedures. Mayo Clinic Proceedings, 74(5), 448-453.

Probable alcohol abuse or dependence : A risk factor for intensive-care readmission in patients undergoing elective vascular and thoracic surgical procedures. / Maxson, Pamela M.; Schultz, Karen L.; Berge, Keith H.; Lange, Carla M.; Schroeder, Darrell R.; Rummans, Teresa A.

In: Mayo Clinic Proceedings, Vol. 74, No. 5, 1999, p. 448-453.

Research output: Contribution to journalArticle

Maxson, Pamela M. ; Schultz, Karen L. ; Berge, Keith H. ; Lange, Carla M. ; Schroeder, Darrell R. ; Rummans, Teresa A. / Probable alcohol abuse or dependence : A risk factor for intensive-care readmission in patients undergoing elective vascular and thoracic surgical procedures. In: Mayo Clinic Proceedings. 1999 ; Vol. 74, No. 5. pp. 448-453.
@article{d8f220bbf4d2422abeb2906211548c19,
title = "Probable alcohol abuse or dependence: A risk factor for intensive-care readmission in patients undergoing elective vascular and thoracic surgical procedures",
abstract = "Objective: To determine whether alcohol abuse or dependence is a risk factor for perioperative complications, increased duration of hospital stay, and increased utilization of nursing resources in patients undergoing thoracic and vascular surgical procedures. Material and Methods: We conducted a prospective study of all adult patients who underwent an elective vascular or thoracic surgical procedure and who received postoperative care in an intensive-care setting. Patients were screened for alcohol abuse or dependence, and actual versus expected durations of stay were evaluated. The patients' medical records were reviewed for preoperative comorbidities and perioperative complications. Fisher's exact test and the rank sum test were used in the analyses. Results: Of 321 study subjects, 290 were classified as nonalcoholic and 31 as probable alcoholic patients. Patients in the probable alcohol abuse group had a significantly increased rate of alcohol withdrawal (12.9{\%} versus 1.7{\%}; P = 0.006) in comparison with patients in the nonalcoholic group. Patients in the probable alcohol abuse group were readmitted to an intensive-care unit more frequently (19.4{\%} versus 7.9{\%}; P = 0.047) and required sedation more often (32.3{\%} versus 13.5{\%}; P = 0.014) than those in the nonalcoholic group. No significant differences were found between the two study groups in intensive-care unit and hospital durations of stay or in utilization of nursing resources. A dismissal diagnosis of alcoholism was recorded for only one of four patients who had a documented withdrawal episode among those categorized in the probable alcoholic group and for three of five patients with alcohol withdrawal symptoms categorized in the nonalcoholic group. Conclusion: Except for the occurrence of alcohol withdrawal syndrome, study patients classified in the probable alcohol abuse group did not have more medical or surgical perioperative complications than patients in the nonalcoholic group. They did have significantly more intensive-care setting readmissions. Patients with documented alcohol withdrawal episodes frequently were dismissed without a diagnosis of substance abuse or dependence.",
author = "Maxson, {Pamela M.} and Schultz, {Karen L.} and Berge, {Keith H.} and Lange, {Carla M.} and Schroeder, {Darrell R.} and Rummans, {Teresa A.}",
year = "1999",
language = "English (US)",
volume = "74",
pages = "448--453",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "5",

}

TY - JOUR

T1 - Probable alcohol abuse or dependence

T2 - A risk factor for intensive-care readmission in patients undergoing elective vascular and thoracic surgical procedures

AU - Maxson, Pamela M.

AU - Schultz, Karen L.

AU - Berge, Keith H.

AU - Lange, Carla M.

AU - Schroeder, Darrell R.

AU - Rummans, Teresa A.

PY - 1999

Y1 - 1999

N2 - Objective: To determine whether alcohol abuse or dependence is a risk factor for perioperative complications, increased duration of hospital stay, and increased utilization of nursing resources in patients undergoing thoracic and vascular surgical procedures. Material and Methods: We conducted a prospective study of all adult patients who underwent an elective vascular or thoracic surgical procedure and who received postoperative care in an intensive-care setting. Patients were screened for alcohol abuse or dependence, and actual versus expected durations of stay were evaluated. The patients' medical records were reviewed for preoperative comorbidities and perioperative complications. Fisher's exact test and the rank sum test were used in the analyses. Results: Of 321 study subjects, 290 were classified as nonalcoholic and 31 as probable alcoholic patients. Patients in the probable alcohol abuse group had a significantly increased rate of alcohol withdrawal (12.9% versus 1.7%; P = 0.006) in comparison with patients in the nonalcoholic group. Patients in the probable alcohol abuse group were readmitted to an intensive-care unit more frequently (19.4% versus 7.9%; P = 0.047) and required sedation more often (32.3% versus 13.5%; P = 0.014) than those in the nonalcoholic group. No significant differences were found between the two study groups in intensive-care unit and hospital durations of stay or in utilization of nursing resources. A dismissal diagnosis of alcoholism was recorded for only one of four patients who had a documented withdrawal episode among those categorized in the probable alcoholic group and for three of five patients with alcohol withdrawal symptoms categorized in the nonalcoholic group. Conclusion: Except for the occurrence of alcohol withdrawal syndrome, study patients classified in the probable alcohol abuse group did not have more medical or surgical perioperative complications than patients in the nonalcoholic group. They did have significantly more intensive-care setting readmissions. Patients with documented alcohol withdrawal episodes frequently were dismissed without a diagnosis of substance abuse or dependence.

AB - Objective: To determine whether alcohol abuse or dependence is a risk factor for perioperative complications, increased duration of hospital stay, and increased utilization of nursing resources in patients undergoing thoracic and vascular surgical procedures. Material and Methods: We conducted a prospective study of all adult patients who underwent an elective vascular or thoracic surgical procedure and who received postoperative care in an intensive-care setting. Patients were screened for alcohol abuse or dependence, and actual versus expected durations of stay were evaluated. The patients' medical records were reviewed for preoperative comorbidities and perioperative complications. Fisher's exact test and the rank sum test were used in the analyses. Results: Of 321 study subjects, 290 were classified as nonalcoholic and 31 as probable alcoholic patients. Patients in the probable alcohol abuse group had a significantly increased rate of alcohol withdrawal (12.9% versus 1.7%; P = 0.006) in comparison with patients in the nonalcoholic group. Patients in the probable alcohol abuse group were readmitted to an intensive-care unit more frequently (19.4% versus 7.9%; P = 0.047) and required sedation more often (32.3% versus 13.5%; P = 0.014) than those in the nonalcoholic group. No significant differences were found between the two study groups in intensive-care unit and hospital durations of stay or in utilization of nursing resources. A dismissal diagnosis of alcoholism was recorded for only one of four patients who had a documented withdrawal episode among those categorized in the probable alcoholic group and for three of five patients with alcohol withdrawal symptoms categorized in the nonalcoholic group. Conclusion: Except for the occurrence of alcohol withdrawal syndrome, study patients classified in the probable alcohol abuse group did not have more medical or surgical perioperative complications than patients in the nonalcoholic group. They did have significantly more intensive-care setting readmissions. Patients with documented alcohol withdrawal episodes frequently were dismissed without a diagnosis of substance abuse or dependence.

UR - http://www.scopus.com/inward/record.url?scp=0032939771&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032939771&partnerID=8YFLogxK

M3 - Article

VL - 74

SP - 448

EP - 453

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 5

ER -