# Alcohol use‐specific treatment initiation among patients undergoing surgical procedures: A retrospective cohort analysis

## TL;DR

This study finds that surgical patients with high alcohol risk scores are more likely to receive treatment, but overall treatment rates remain very low.

## Contribution

The study identifies a significant gap between alcohol risk identification and treatment initiation in surgical patients.

## Key findings

- Only 0.5% of surgical patients received alcohol-related treatment within 90 days of a procedure.
- High-risk and severe-risk patients had significantly increased odds of receiving treatment.
- Despite higher odds, less than 5% of severe-risk patients received treatment.

## Abstract

Alcohol use is common in surgical patients and linked to morbidity and mortality. Yet, alcohol screening and treatment are frequently overlooked in perioperative care. This study examines how patient risk for unhealthy alcohol use is associated with the likelihood of receiving any treatment for the purpose of alcohol risk reduction or cessation.

All records from surgical patients with quantifiable Alcohol Use Disorders Identification Test—Consumption (AUDIT‐C) scores in the All of Us Research Program, a precision medicine‐focused database harmonizing surveys and electronic health records, were evaluated. The association between treatment for at‐risk alcohol use, including psychotherapy and pharmacologic therapy, and categorical AUDIT‐C risk was estimated using adjusted multivariable logistic regression models.

Any alcohol use treatments were initiated in 0.5% of patients within 90 days of a procedure. Patients in high‐risk and severe‐risk AUDIT‐C groups had significantly increased odds of receiving any treatment (aOR 2.37, 95% CI 1.06, 4.74; aOR 10.1, 95% CI 6.02, 16.8). Similarly, participants with an alcohol use disorder (AUD) diagnosis were nine times more likely to receive any treatment than those without a diagnosis (aOR 9.33, 95% CI 5.97, 14.70). Yet only 0.7% of high‐risk, 4% of severe‐risk AUDIT‐C participants, and 1.7% of participants diagnosed with AUD received any treatment.

Surgical patients with identified severe risk for unhealthy alcohol consumption are more likely to receive perioperative alcohol‐specific treatment. However, even for high‐risk patients, the provision of perioperative treatments to reduce alcohol intake is rare. Future work should focus on overcoming barriers to reduce unhealthy alcohol use after surgery.

Although surgical patients with higher Alcohol Use Disorders Identification Test (AUDIT‐C) risk scores have increased odds of receiving treatment to reduce alcohol use, overall treatment rates within 90 days before or after surgery are exceedingly low—less than 5% in the severe‐risk group (AUDIT‐C score 8–12). A significant gap exists between identified alcohol use risks and treatment in perioperative care. More widespread, effective implementation of targeted screening and intervention strategies is needed to address unhealthy alcohol use among surgical patients.