Cochrane Summaries

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The effect of alcohol cessation on complications following surgery

Oppedal K, Møller AM, Pedersen B, Tønnesen H
Published Online: 
30 April 2013

Hazardous drinking affects human health in several ways, even in patients without an alcohol-related disease. These include an increased risk of surgical complications. In addition to the well known alcohol-induced disorders of the liver, pancreas, and nervous system; heavy drinking affects cardiac function, immune capacity (the body's ability to defend itself against infections), haemostasis (blood clot formation), and surgical stress responses. Cardiac insufficiency and arrhythmias (a disorder of the heart rate) are common among hazardous drinkers. Both are important risk factors for the development of postoperative complications, such as postoperative infections, cardiopulmonary complications (heart and lung complications), and bleeding episodes. Reduced immune capacity is found in most patients drinking three or more alcohol units (AU) per day.

The objective of this review was to assess the effect of alcohol interventions on complications following surgery. Interventions included all alcohol interventions aimed at helping patients to either quit drinking or to reduce their alcohol consumption before surgery. We identified two relevant studies involving 69 patients. Both studies involved intensive alcohol interventions aimed at complete alcohol cessation before surgery. The interventions included pharmacological (drug) strategies for alcohol withdrawal and relapse prophylaxis (relapse prevention) and were four to eight weeks in length (these interventions are comparable to the gold standard smoking cessation interventions).

The results showed that intensive interventions aimed at complete alcohol cessation reduced the number of complications. No effect was found on mortality rates (number of deaths) and length of stay.

Due to the small number of included studies, as well as the small size of the included studies, one should be careful about drawing firm conclusions based upon these results. More research is needed to clarify the most beneficial intervention programme. This includes research on the effect of reduced alcohol consumption and the most beneficial period of alcohol intervention programmes. However, as recruitment of patients to this field of research seems challenging, these studies may be difficult to perform.

This record should be cited as: 
Oppedal K, Møller AM, Pedersen B, Tønnesen H. Preoperative alcohol cessation prior to elective surgery. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.: CD008343. DOI: 10.1002/14651858.CD008343.pub2
Assessed as up to date: 
22 September 2011