AUDIT-C alcohol screening results and postoperative inpatient health care use

Anna D. Rubinsky, Haili Sun, David K. Blough, Charles Maynard, Christopher L. Bryson, Alex H. Harris, Eric J. Hawkins, Lauren A. Beste, William G. Henderson, Mary T. Hawn, Grant Hughes, Michael J. Bishop, Ruth Etzioni, Hanne Tønnesen, Daniel R. Kivlahan, Katharine A. Bradley

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Alcohol screening scores ≥5 on the Alcohol Use Disorders Identification TestConsumption (AUDIT-C) up to a year before surgery have been associated with postoperative complications, but the association with postoperative health care use is unknown. This study evaluated whether AUDIT-C scores in the year before surgery were associated with postoperative hospital length of stay, total ICU days, return to the operating room, and hospital readmission. Study Design: This cohort study included male Veterans Affairs patients who completed the AUDIT-C on mailed surveys (October 2003 through September 2006) and were hospitalized for nonemergent noncardiac major operations in the following year. Postoperative health care use was evaluated across 4 AUDIT-C risk groups (scores 0, 1 to 4, 5 to 8, and 9 to 12) using linear or logistic regression models adjusted for sociodemographics, smoking status, surgical category, relative value unit, and time from AUDIT-C to surgery. Patients with AUDIT-C scores indicating low-risk drinking (scores 1 to 4) were the referent group. Results: Adjusted analyses revealed that among eligible surgical patients (n = 5,171), those with the highest AUDIT-C scores (ie, 9 to 12) had longer postoperative hospital length of stay (5.8 [95% CI, 5.0-6.7] vs 5.0 [95% CI, 4.7-5.3] days), more ICU days (4.5 [95% CI, 3.2-5.8] vs 2.8 [95% CI, 2.6-3.1] days), and increased probability of return to the operating room (10% [95% CI, 6-13%] vs 5% [95% CI, 4-6%]) in the 30 days after surgery, but not increased hospital readmission within 30 days postdischarge, relative to the low-risk group. Conclusions: AUDIT-C screening results could be used to identify patients at risk for increased postoperative health care use who might benefit from preoperative alcohol interventions.

Original languageEnglish (US)
JournalJournal of the American College of Surgeons
Volume214
Issue number3
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

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Inpatients
Alcohols
Delivery of Health Care
Postoperative Care
Length of Stay
Patient Readmission
Operating Rooms
Logistic Models
Veterans
Ambulatory Surgical Procedures
Drinking
Linear Models
Cohort Studies
Smoking

ASJC Scopus subject areas

  • Surgery

Cite this

Rubinsky, A. D., Sun, H., Blough, D. K., Maynard, C., Bryson, C. L., Harris, A. H., ... Bradley, K. A. (2012). AUDIT-C alcohol screening results and postoperative inpatient health care use. Journal of the American College of Surgeons, 214(3). https://doi.org/10.1016/j.jamcollsurg.2011.11.007

AUDIT-C alcohol screening results and postoperative inpatient health care use. / Rubinsky, Anna D.; Sun, Haili; Blough, David K.; Maynard, Charles; Bryson, Christopher L.; Harris, Alex H.; Hawkins, Eric J.; Beste, Lauren A.; Henderson, William G.; Hawn, Mary T.; Hughes, Grant; Bishop, Michael J.; Etzioni, Ruth; Tønnesen, Hanne; Kivlahan, Daniel R.; Bradley, Katharine A.

In: Journal of the American College of Surgeons, Vol. 214, No. 3, 01.01.2012.

Research output: Contribution to journalArticle

Rubinsky, AD, Sun, H, Blough, DK, Maynard, C, Bryson, CL, Harris, AH, Hawkins, EJ, Beste, LA, Henderson, WG, Hawn, MT, Hughes, G, Bishop, MJ, Etzioni, R, Tønnesen, H, Kivlahan, DR & Bradley, KA 2012, 'AUDIT-C alcohol screening results and postoperative inpatient health care use', Journal of the American College of Surgeons, vol. 214, no. 3. https://doi.org/10.1016/j.jamcollsurg.2011.11.007
Rubinsky, Anna D. ; Sun, Haili ; Blough, David K. ; Maynard, Charles ; Bryson, Christopher L. ; Harris, Alex H. ; Hawkins, Eric J. ; Beste, Lauren A. ; Henderson, William G. ; Hawn, Mary T. ; Hughes, Grant ; Bishop, Michael J. ; Etzioni, Ruth ; Tønnesen, Hanne ; Kivlahan, Daniel R. ; Bradley, Katharine A. / AUDIT-C alcohol screening results and postoperative inpatient health care use. In: Journal of the American College of Surgeons. 2012 ; Vol. 214, No. 3.
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abstract = "Background: Alcohol screening scores ≥5 on the Alcohol Use Disorders Identification TestConsumption (AUDIT-C) up to a year before surgery have been associated with postoperative complications, but the association with postoperative health care use is unknown. This study evaluated whether AUDIT-C scores in the year before surgery were associated with postoperative hospital length of stay, total ICU days, return to the operating room, and hospital readmission. Study Design: This cohort study included male Veterans Affairs patients who completed the AUDIT-C on mailed surveys (October 2003 through September 2006) and were hospitalized for nonemergent noncardiac major operations in the following year. Postoperative health care use was evaluated across 4 AUDIT-C risk groups (scores 0, 1 to 4, 5 to 8, and 9 to 12) using linear or logistic regression models adjusted for sociodemographics, smoking status, surgical category, relative value unit, and time from AUDIT-C to surgery. Patients with AUDIT-C scores indicating low-risk drinking (scores 1 to 4) were the referent group. Results: Adjusted analyses revealed that among eligible surgical patients (n = 5,171), those with the highest AUDIT-C scores (ie, 9 to 12) had longer postoperative hospital length of stay (5.8 [95{\%} CI, 5.0-6.7] vs 5.0 [95{\%} CI, 4.7-5.3] days), more ICU days (4.5 [95{\%} CI, 3.2-5.8] vs 2.8 [95{\%} CI, 2.6-3.1] days), and increased probability of return to the operating room (10{\%} [95{\%} CI, 6-13{\%}] vs 5{\%} [95{\%} CI, 4-6{\%}]) in the 30 days after surgery, but not increased hospital readmission within 30 days postdischarge, relative to the low-risk group. Conclusions: AUDIT-C screening results could be used to identify patients at risk for increased postoperative health care use who might benefit from preoperative alcohol interventions.",
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AU - Bryson, Christopher L.

AU - Harris, Alex H.

AU - Hawkins, Eric J.

AU - Beste, Lauren A.

AU - Henderson, William G.

AU - Hawn, Mary T.

AU - Hughes, Grant

AU - Bishop, Michael J.

AU - Etzioni, Ruth

AU - Tønnesen, Hanne

AU - Kivlahan, Daniel R.

AU - Bradley, Katharine A.

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N2 - Background: Alcohol screening scores ≥5 on the Alcohol Use Disorders Identification TestConsumption (AUDIT-C) up to a year before surgery have been associated with postoperative complications, but the association with postoperative health care use is unknown. This study evaluated whether AUDIT-C scores in the year before surgery were associated with postoperative hospital length of stay, total ICU days, return to the operating room, and hospital readmission. Study Design: This cohort study included male Veterans Affairs patients who completed the AUDIT-C on mailed surveys (October 2003 through September 2006) and were hospitalized for nonemergent noncardiac major operations in the following year. Postoperative health care use was evaluated across 4 AUDIT-C risk groups (scores 0, 1 to 4, 5 to 8, and 9 to 12) using linear or logistic regression models adjusted for sociodemographics, smoking status, surgical category, relative value unit, and time from AUDIT-C to surgery. Patients with AUDIT-C scores indicating low-risk drinking (scores 1 to 4) were the referent group. Results: Adjusted analyses revealed that among eligible surgical patients (n = 5,171), those with the highest AUDIT-C scores (ie, 9 to 12) had longer postoperative hospital length of stay (5.8 [95% CI, 5.0-6.7] vs 5.0 [95% CI, 4.7-5.3] days), more ICU days (4.5 [95% CI, 3.2-5.8] vs 2.8 [95% CI, 2.6-3.1] days), and increased probability of return to the operating room (10% [95% CI, 6-13%] vs 5% [95% CI, 4-6%]) in the 30 days after surgery, but not increased hospital readmission within 30 days postdischarge, relative to the low-risk group. Conclusions: AUDIT-C screening results could be used to identify patients at risk for increased postoperative health care use who might benefit from preoperative alcohol interventions.

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