Preoperative evaluation of alcohol consumption in older patients

TL;DR

This study compared two methods for assessing alcohol consumption in older patients before surgery, finding that the AUDIT-C questionnaire is more effective than a single question.

Contribution

The study demonstrates that the AUDIT-C questionnaire provides more accurate and reliable alcohol consumption data in older patients compared to a single question.

Findings

The AUDIT-C identified more patients with moderate to high alcohol consumption than the single sentence question.

About 25% of patients who denied daily alcohol intake had moderate to high consumption according to the AUDIT-C.

Using the AUDIT-C encourages self-assessment and reduces the perception of moral judgment during consultations.

Abstract

This sub-analysis of the PROPDESC-study (Pre-Operative Prediction of postoperative delirium by appropriate Screening-study) evaluated the alcohol consumption of older patients with two different assessment tools (single sentence question and Alcohol Use Disorder Identification Test-Consumption (AUDIT-C)) and compared the results in regards to detection, reliability, and quantification of patient´s alcohol consumption.

During their anesthesiological pre-clinic visit 1084 patients older than 59 years were asked whether they consume alcohol daily and 668 of them additionally answered the AUDIT-C questionnaire.

According to the SSQ 11.72% of the patients consumed alcohol daily. In the AUDIT-C sub-group 25.90% reported moderate to high alcohol consumption while infrequent or very low alcohol intake was reported by 41.92%. In the subgroup 31.89% of the patients stated alcohol abstinence. About one quarter (25.13%) of patients who denied daily alcohol intake but scored positive on the AUDIT-C displayed levels of alcohol consumption ranging from moderate (11.20%) to high (13.87%) according to the AUDIT-C.

Reliable information about alcohol consumption is related to the method of questioning. The AUDIT-C evaluates the patient´s alcohol intake precisely and identifies more older patients with possibly health- and surgery-relevant alcohol consumption levels. The validated AUDIT-C provides an objective assessment to the physician during the pre-clinic anesthesiologic consultation. Additionally, handing out a questionnaire to the patient encourages initiative and self-assessment and could also relieve both, the physician and the patient from sensing a moral evaluation of alcohol consumption.

The online version contains supplementary material available at 10.1186/s13722-025-00569-8.

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