Patients developing alcohol withdrawal syndrome (AWS) after major surgery face increased risks of complications, longer hospital stays and higher healthcare costs,
This is according to a study in the Journal of the American College of Surgeons .
Now, a national study in the US has reiterated the importance of perioperative screening and targeted interventions to cut complications.
Using the National Inpatient Sample (2016–2019), researchers examined data from three million adults undergoing major operations, including colectomy, cardiac surgery, and liver resection.
Of these, 16,504 (0.5%) were diagnosed with AWS, with 6,591 (0.2%) experiencing life-threatening delirium tremens (DT), which can include tremors, confusion and hallucinations.
Lead author Timothy M Pawlik, MD, surgeon-in-chief at Ohio State University Wexner Medical Centre, said: ‘AWS is a preventable complication but often overlooked in surgical planning. Our research indicates that proactive screening and multidisciplinary care – involving surgeons, social workers, and addiction specialists – can save lives and reduce costs.’
Key findings included:
• High-risk groups: AWS was more prevalent among men (median age 61), Medicaid recipients and patients with substance use disorders.
• Increased complications: AWS doubled the risk of respiratory failure and sepsis. DT raised mortality rates by 40%.
• Economic impact: Adjusted hospitalisation costs increased by $10,030 per AWS patient; DT added another $5,300.
Future strategies suggested were:
• Preoperative screening: Utilise validated tools (e.g., AUDIT-C) to identify patients at high risk.
• Compassionate care: ‘This is a disease, not a moral failing,’ stressed Dr Pawlik. ‘Honest discussions are needed to tailor treatment.’
• Early intervention: For at-risk patients, preventative medications (e.g., benzodiazepines) and ICU monitoring may prevent DT.
Recalling a case where AWS led to aspiration pneumonia, Dr Pawlik explained: ‘Post-surgery recovery should not be compromised by withdrawal. Addressing alcohol use beforehand and ensuring safer recovery environments can make a difference.’
The study used administrative data, which might underestimate AWS incidence. Long-term outcomes and treatment specifics (e.g., benzodiazepine use) were not evaluated.
