title: AUDIT-C alcohol screening results and postoperative inpatient health care use.
abstract: BACKGROUND
  Alcohol screening scores ≥5 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.
  
  
  METHODS
  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.
  
  
  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, 5.0-6.7] vs 5.0 [95% CI, 4.7-5.3] days), more ICU days (4.5 [95% CI, 3.2-5.8] vs 2.8 [95% CI, 2.6-3.1] days), and increased probability of return to the operating room (10% [95% CI, 6-13%] vs 5% [95% CI, 4-6%]) in the 30 days after surgery, but not increased hospital readmission within 30 days postdischarge, relative to the low-risk group.
  
  
  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.
authors.affiliation: Health Services Research and Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA. Anna.Rubinsky@va.gov
authors.forename: Anna D
authors.initials: AD
authors.lastname: Rubinsky
authors.forename: Haili
authors.initials: H
authors.lastname: Sun
authors.forename: David K
authors.initials: DK
authors.lastname: Blough
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Bryson
authors.forename: Alex H
authors.initials: AH
authors.lastname: Harris
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hawkins
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Beste
authors.forename: William G
authors.initials: WG
authors.lastname: Henderson
authors.forename: Mary T
authors.initials: MT
authors.lastname: Hawn
authors.forename: Grant
authors.initials: G
authors.lastname: Hughes
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bishop
authors.forename: Ruth
authors.initials: R
authors.lastname: Etzioni
authors.forename: Hanne
authors.initials: H
authors.lastname: Tønnesen
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kivlahan
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Bradley
mesh_terms: D000368:Aged; D000428:Alcohol Drinking; D000437:Alcoholism / Q000175:diagnosis*; D015331:Cohort Studies; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011182:Postoperative Care / Q000706:statistics & numerical data*; D011184:Postoperative Period; D012044:Regression Analysis; D012086:Reoperation; D011795:Surveys and Questionnaires