Dags för "alkoholfri operation". Två standardglas per dag fördubblar risken för postoperativa komplikationer
Engelsk titel: Time for "alcohol-free operations". Two standard drinks a day doubles the risk of postoperative complications
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Författare:
Wåhlin, Sven
;
Tönnesen, Hanne
Email: sven.wahlin@sll.se
Språk: Swe
Antal referenser: 33
Dokumenttyp:
Översikt
UI-nummer: 14117569
Sammanfattning
Increasing evidence points out that alcohol intake is a significant risk factor for patient safety at surgery. This review updates the evidence, mechanisms and recommendations.
The threshold is relatively low; about two standard drinks per day or more for two weeks prior to surgery double the complication rate. The mechanisms include reduced immune
capacity, sub-clinical cardiomyopathy, haemostatic imbalance, delayed wound healing and increased stress response to surgery. These organ dysfunctions are significantly improved
or even normalised during total abstinence from alcohol for 1 to 9 weeks. Only two RCTs has been performed to evaluate the effect of intenssive alcohol intervention prior to elective
surgery. A 70 % reduction of postoperative complications was shown in a meta-analysis. The intervention targeted complete alcohol cessation, with a high success rate. Research on
acute surgery is missing. We recommend that patients are given information on alcohol and increased surgical risk, that alcohol history taking is standardised and that evidence-based
intervention programs for risk reduction are included in the surgical guidelines in order to improve the patient safety.