AUDIT-C Alcohol Screening Results and Postoperative Inpatient Health Care Use

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• 作者：Anna D. Rubinsky ; MS^a ; ^d ; ^{Anna.Rubinsky@va.gov} ; Haili Sun ; PhD^a ; David K. Blough ; PhD^a ; ^e ; Charles Maynard ; PhD^a ; ^d ; Christopher L. Bryson ; MD ; MS^a ; ^b ; Alex H. Harris ; PhD^l ; Eric J. Hawkins ; PhD^a ; ^c ; ^f ; Lauren A. Beste ; MD ; MS^b ; William G. Henderson ; PhD^m ; ⁿ ; Mary T. Hawn ; MD ; MPH ; FACS^o ; ^p ; Grant Hughes ; BS^m ; Michael J. Bishop ; MD^g ; Ruth Etzioni ; PhD^d ; ^h ; ^j ; Hanne Tø ; nnesen ; MD ; DMSc^q ; Daniel R. Kivlahan ; PhD^a ; ^c ; ^f ; Katharine A. Bradley ; MD ; MPH^a ; ^b ; ^c ; ^d ; ⁱ ; ^k
• 关键词：AUDIT-C ; Alcohol Use Disorders Identification Test&ndash ; Consumption ; CPT ; Current Procedural Terminology ; LOS ; length of stay ; NPCD ; National Patient Care Database ; OR ; operating room ; RVU ; relative value unit ; SHEP ; Survey of Healthcare Experiences of P
• 刊名：Journal of the American College of Surgeons
• 出版年：2012
• 期刊代码：175_10727515
• 类别：med
• 出版时间：March, 2012
• 卷：214
• 期：3
• 页码：296-305.e1
• 文件大小：288 K

摘要

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class="h4">Background

Alcohol screening scores 鈮? on the Alcohol Use Disorders Identification Test-Consumption (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.

class="h4">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.

class="h4">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鈭?.7] vs 5.0 [95%CI, 4.7鈭?.3] days), more ICU days (4.5 [95%CI, 3.2鈭?.8] vs 2.8 [95%CI, 2.6鈭?.1] days), and increased probability of return to the operating room (10%[95%CI, 6鈭?3%] vs 5%[95%CI, 4鈭?%]) in the 30 days after surgery, but not increased hospital readmission within 30 days postdischarge, relative to the low-risk group.

class="h4">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.