Effectiveness of preoperative management of alcohol use disorders in surgical patients: a systematic review and meta-analysis.

BACKGROUND

Alcohol use disorders (AUD) are associated with significant health risks in surgical patients, including increased in postoperative morbidity and mortality. Treatment of alcohol use disorders prevents adverse organ dysfunction and reduces postoperative complications. This systematic review and meta-analysis aim to assess the effectiveness of existing preoperative alcohol use disorder interventions on postoperative outcomes.

METHODS

MEDLINE, Embase, and Cochrane databases were searched for English-language studies involving adults undergoing surgery. Eligible studies compared preoperative alcohol use disorder interventions with no intervention and reported postoperative outcomes, including postoperative complications, length of stay, alcohol recidivism, and mortality.

RESULTS

Twenty-one studies (N.=2602) were included. Eighteen studies used non-pharmacological interventions, one utilized pharmacological monotherapy, and two provided combined interventions. At 1-year and greater than 5-year follow-ups, the intervention groups had a significant reduction in participants who relapsed to alcohol drinking (1-year follow-up: RR: 0.59; 95% CI: 0.37-0.95; 5-year follow-up: RR: 0.53; 95% CI: 0.33-0.85, respectively). No significant pooled effects were found for postoperative complications, length of hospital stay, or mortality.

CONCLUSIONS

Preoperative interventions for alcohol use disorders reduce alcohol relapse in liver transplant populations. Given the strong link between preoperative alcohol use and postoperative risks, additional research on preoperative alcohol cessation interventions is needed.