Arthroplasty knee surgery and alcohol use: risk factor or benefit?
BACKGROUND
Excessive alcohol consumption has been associated with adverse measures of health after elective surgery. However, associations of low/moderate consumption remain uncertain.


OBJECTIVE
We determined differences among patients with three different self-reported consumption levels in (1) preoperative/postoperative patient-perceived outcomes and knee scores, (2) preoperative/postoperative changes in these scores, (3) preoperative demographics and comorbidities, and (4) length of stay (LOS) and inpatient charges.


METHODS
We retrospectively studied 430 patients (545 TKAs). Based on a self-administered consumption questionnaire, patients were stratified into groups: (1) nondrinkers, (2) occasional drinkers, and (3) moderate drinkers. We compared the following variables between groups: demographics, BMI, American Society of Anesthesiologists score, Charlson Comorbidity Index, preoperative and postoperative Quality of Well-being Index (QWB-7), SF-36 score, WOMAC score, Knee Society (KS) Score, Hospital for Special Surgery (HSS) knee score, LOS, and hospital charges. QWB-7, SF-36, WOMAC, KS, and HSS scores were compared adjusting for patient characteristics. Minimum followup was 1 year (average, 3.4 years; range, 1-6 years).


RESULTS
Preoperatively, compared to self-reported nondrinkers, moderate drinkers had better QWB-7, SF-36, and WOMAC scores. At followup, occasional and moderate drinkers had better KS function and HSS scores. However, nondrinkers had greater SF-36 general health improvement. Most nondrinkers were older, female, and Hispanic and had more comorbidities. Nondrinkers had a longer LOS.


CONCLUSIONS
Self-reported alcohol consumption was more common among men and non-Hispanics. Moderate drinkers had better preoperative QWB-7, SF-36, and WOMAC scores and shorter LOS than nondrinkers. However, after surgery, self-reported abstainers achieved greater improvements in the SF-36 general health score.
Orthopaedic Institute at Mercy Hospital, 3659 S Miami Avenue, Suite 4008, Miami, FL 33133, USA. C@DRLAVERNIA.COM
Carlos J
CJ
Lavernia
Jesus M
JM
Villa
Juan S
JS
Contreras
D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome