Alcohol Consumption and the Risk of Postoperative Mortality and Morbidity After Primary Hip or Knee Arthroplasty - A Register-based Cohort Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2017 Mar 18

PMID 28306737

Citations 11

Authors

Torill A Rotevatn

Henrik Boggild

Christinna R Olesen

Christian Torp-Pedersen

Rikke N Mortensen

Per F Jensen

Charlotte Overgaard

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the implications of low and moderate preoperative alcohol consumption on postoperative mortality and morbidity after primary hip and knee arthroplasty.

Methods: A total of 30,799 patients who underwent primary hip or knee arthroplasty between January 1st, 2005 and October 8th, 2011 with information on preoperative alcohol consumption (0 grams of pure alcohol/week, >0-168 g/week, >168-252 g/week, and >252 g/week) were identified through the Danish Anesthesia Database. The 90-day and 1-year risks of mortality (primary outcomes), 1-year risk of prosthetic infection, and 30-day risks of cardiovascular disease and deep venous thrombosis (secondary outcomes) were estimated by Cox regression analysis.

Results: We identified 285 (0.9%) deaths within the first 90 days and 694 (2.3%) within the first year. Within the first 30 days, 209 (0.7%) and 270 (0.9%) patients had acquired cardiovascular disease and deep venous thrombosis, respectively, and 514 (1.7%) patients developed prosthetic infection within the first year. The adjusted mortality models yielded hazard ratios of 0.55 (95% confidence interval [CI] 0.41 to 0.74) at 90 days and 0.61 (95% CI 0.51 to 0.73) at 1 year for the group consuming >0-168 g/week when compared to abstainers. Adjusted hazard ratios showed that the group consuming >0-168 g/week had a 0.91 (95% CI 0.75 to 1.11) risk of prosthetic infection, 0.68 (95% CI 0.50 to 0.92) risk of cardiovascular disease and 0.88 (95% CI 0.67 to 1.15) risk of deep venous thrombosis when compared to abstainers.

Conclusions: This study demonstrates that low-to-moderate alcohol consumption prior to primary hip or knee arthroplasty is associated with lower risks of mortality at both 90 days and 1 year after surgery and of cardiovascular disease after 30 days. More research from longitudinal studies is needed to identify specific causal relations and explanations.

Citing Articles

Genetic and Modifiable Risk Factors for Postoperative Complications of Total Joint Arthroplasty: A Genome-Wide Association and Mendelian Randomization Study.

Guo S, Zhang J, Li H, Cheng C, Zhang J Bioengineering (Basel). 2024; 11(8).

PMID: 39199755 PMC: 11351150. DOI: 10.3390/bioengineering11080797.

Long-Term Survival Analysis of 5619 Total Ankle Arthroplasty and Patient Risk Factors for Failure.

Subramanian S, Kim H, Kim S, Hwang J, Lee D, Rhim H J Clin Med. 2024; 13(1).

PMID: 38202186 PMC: 10779937. DOI: 10.3390/jcm13010179.

Outcomes of total hip and knee arthroplasty in special populations: a synopsis and critical appraisal of systematic reviews.

Challoumas D, Munn D, Stockdale H, Ng N, McCormick M, Altell T Arthroplasty. 2023; 5(1):34.

PMID: 37408050 PMC: 10324116. DOI: 10.1186/s42836-023-00190-7.

Prehabilitation in Patients before Major Surgery: A Review Article.

Shakya P, Poudel S JNMA J Nepal Med Assoc. 2023; 60(254):909-915.

PMID: 36705159 PMC: 9924929. DOI: 10.31729/jnma.7545.

How to Distinguish Correlation From Causation in Orthopaedic Research.

Zaniletti I, Larson D, Lewallen D, Berry D, Kremers H J Arthroplasty. 2022; 38(4):634-637.

PMID: 36481283 PMC: 10010939. DOI: 10.1016/j.arth.2022.11.019.

References

Rehm J, Gmel G, Sempos C, Trevisan M . Alcohol-related morbidity and mortality. Alcohol Res Health. 2004; 27(1):39-51. PMC: 6676700. View

Mason K, Thygesen L, Stenager E, Bronnum-Hansen H, Koch-Henriksen N . Evaluating the use and limitations of the Danish National Patient Register in register-based research using an example of multiple sclerosis. Acta Neurol Scand. 2011; 125(3):213-7. DOI: 10.1111/j.1600-0404.2011.01558.x. View

Nath B, Li Y, Carroll J, Szabo G, Tseng J, Shah S . Alcohol exposure as a risk factor for adverse outcomes in elective surgery. J Gastrointest Surg. 2010; 14(11):1732-41. DOI: 10.1007/s11605-010-1350-4. View

Ekholm O, Strandberg-Larsen K, Gronbaek M . Influence of the recall period on a beverage-specific weekly drinking measure for alcohol intake. Eur J Clin Nutr. 2011; 65(4):520-5. DOI: 10.1038/ejcn.2011.1. View

Davis C, Thake J, Vilhena N . Social desirability biases in self-reported alcohol consumption and harms. Addict Behav. 2009; 35(4):302-11. DOI: 10.1016/j.addbeh.2009.11.001. View

Rubinsky A, Bishop M, Maynard C, Henderson W, Hawn M, Harris A . Postoperative risks associated with alcohol screening depend on documented drinking at the time of surgery. Drug Alcohol Depend. 2013; 132(3):521-7. DOI: 10.1016/j.drugalcdep.2013.03.022. View

Papanikolaou P, Christidi G, Ioannidis J . Comparison of evidence on harms of medical interventions in randomized and nonrandomized studies. CMAJ. 2006; 174(5):635-41. PMC: 1389826. DOI: 10.1503/cmaj.050873. View

White I, Altmann D, Nanchahal K . Alcohol consumption and mortality: modelling risks for men and women at different ages. BMJ. 2002; 325(7357):191. PMC: 117446. DOI: 10.1136/bmj.325.7357.191. View

Stockwell T, Zhao J, MacDonald S . Who under-reports their alcohol consumption in telephone surveys and by how much? An application of the 'yesterday method' in a national Canadian substance use survey. Addiction. 2014; 109(10):1657-66. DOI: 10.1111/add.12609. View

10.

Pedersen C . The Danish Civil Registration System. Scand J Public Health. 2011; 39(7 Suppl):22-5. DOI: 10.1177/1403494810387965. View

11.

Daabiss M . American Society of Anaesthesiologists physical status classification. Indian J Anaesth. 2011; 55(2):111-5. PMC: 3106380. DOI: 10.4103/0019-5049.79879. View

12.

Bozic K, Ong K, Lau E, Berry D, Vail T, Kurtz S . Estimating risk in Medicare patients with THA: an electronic risk calculator for periprosthetic joint infection and mortality. Clin Orthop Relat Res. 2012; 471(2):574-83. PMC: 3549162. DOI: 10.1007/s11999-012-2605-z. View

13.

Gmel G, Gutjahr E, Rehm J . How stable is the risk curve between alcohol and all-cause mortality and what factors influence the shape? A precision-weighted hierarchical meta-analysis. Eur J Epidemiol. 2003; 18(7):631-42. DOI: 10.1023/a:1024805021504. View

14.

Ronksley P, Brien S, Turner B, Mukamal K, Ghali W . Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011; 342:d671. PMC: 3043109. DOI: 10.1136/bmj.d671. View

15.

Charlson M, Pompei P, Ales K, MacKenzie C . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-83. DOI: 10.1016/0021-9681(87)90171-8. View

16.

Voskuijl T, Hageman M, Ring D . Higher Charlson Comorbidity Index Scores are associated with readmission after orthopaedic surgery. Clin Orthop Relat Res. 2013; 472(5):1638-44. PMC: 3971213. DOI: 10.1007/s11999-013-3394-8. View

17.

Clement N, Muzammil A, MacDonald D, Howie C, Biant L . Socioeconomic status affects the early outcome of total hip replacement. J Bone Joint Surg Br. 2011; 93(4):464-9. DOI: 10.1302/0301-620X.93B4.25717. View

18.

Bobo J, Husten C . Sociocultural influences on smoking and drinking. Alcohol Res Health. 2005; 24(4):225-32. PMC: 6709745. View

19.

Singh J, Houston T, Ponce B, Maddox G, Bishop M, Richman J . Smoking as a risk factor for short-term outcomes following primary total hip and total knee replacement in veterans. Arthritis Care Res (Hoboken). 2011; 63(10):1365-74. DOI: 10.1002/acr.20555. View

20.

Ponce B, Oladeji L, Raley J, Menendez M . Analysis of perioperative morbidity and mortality in shoulder arthroplasty patients with preexisting alcohol use disorders. J Shoulder Elbow Surg. 2014; 24(2):167-73. DOI: 10.1016/j.jse.2014.05.019. View