Alcohol withdrawal syndrome is a hidden surgery risk, study finds

Alcohol withdrawal syndrome (AWS) is a potentially life-threatening condition that may complicate patients’ recovery after surgery.

About 28.9 million people age 12 and older in the United States have alcohol use disorder (AUD), according to the National Survey on Drug Use and Health.

Previous studies have estimated that up to 50% of hospitalized patients with AUD will develop some degree of AWS. Up to 7% of these patients may progress to severe withdrawal, including delirium tremens (DT) that can range in severity from irritability and confusion to tremors, nausea, vomiting and seizures.

A new study by surgeons at The Ohio State University Wexner Medical Center and The Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC—James) looked at a national sample of 3 million adult surgical patients between 2016 and 2019. Of those patients, 16,504 (0.5%) were diagnosed with AWS, including 6,591 (0.2%) with DT.

“We found that alcohol withdrawal syndrome is linked with poorer surgical outcomes, extended hospitalizations and increased costs. These findings underscore the need for standardized perioperative screening and targeted management strategies to reduce these risks,” said study lead author Timothy Pawlik, MD, Ph.D., professor and chair of Ohio State’s Department of Surgery.

The study findings were published today in the Journal of the American College of Surgeons.

Patients with AWS were generally younger, male and more likely to have Medicaid, according to Pawlik, who holds the Urban Meyer III and Shelley Meyer Chair for Cancer Research at The Ohio State University College of Medicine.

AWS raises the risk of postoperative complications, especially respiratory failure and sepsis. The study found that patients with AWS had longer hospital stays (median 11 vs. 6 days) and higher costs ($44,300 vs. $28,800).

AWS was associated with a $10,030 higher adjusted hospitalization cost per patient undergoing surgical care, contributing to an overall excess cost of $165.6 million, said study first author Azza Sarfraz, MBBS, a surgical oncology fellow at Ohio State.

“The lack of standard screening delays early detection and intervention,” Pawlik said. “Developing strategies for early identification, inpatient withdrawal management, and perioperative risk stratification may improve surgical outcomes, lower health care costs, and enhance patient care.”

Alcohol withdrawal syndrome (AWS) is a potentially life-threatening condition that may complicate patients’ recovery after surgery.

About 28.9 million people age 12 and older in the United States have alcohol use disorder (AUD), according to the National Survey on Drug Use and Health.

Previous studies have estimated that up to 50% of hospitalized patients with AUD will develop some degree of AWS. Up to 7% of these patients may progress to severe withdrawal, including delirium tremens (DT) that can range in severity from irritability and confusion to tremors, nausea, vomiting and seizures.

A new study by surgeons at The Ohio State University Wexner Medical Center and The Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC—James) looked at a national sample of 3 million adult surgical patients between 2016 and 2019. Of those patients, 16,504 (0.5%) were diagnosed with AWS, including 6,591 (0.2%) with DT.

“We found that alcohol withdrawal syndrome is linked with poorer surgical outcomes, extended hospitalizations and increased costs. These findings underscore the need for standardized perioperative screening and targeted management strategies to reduce these risks,” said study lead author Timothy Pawlik, MD, Ph.D., professor and chair of Ohio State’s Department of Surgery.

The study findings were published today in the Journal of the American College of Surgeons.

Patients with AWS were generally younger, male and more likely to have Medicaid, according to Pawlik, who holds the Urban Meyer III and Shelley Meyer Chair for Cancer Research at The Ohio State University College of Medicine.

AWS raises the risk of postoperative complications, especially respiratory failure and sepsis. The study found that patients with AWS had longer hospital stays (median 11 vs. 6 days) and higher costs ($44,300 vs. $28,800).

AWS was associated with a $10,030 higher adjusted hospitalization cost per patient undergoing surgical care, contributing to an overall excess cost of $165.6 million, said study first author Azza Sarfraz, MBBS, a surgical oncology fellow at Ohio State.

“The lack of standard screening delays early detection and intervention,” Pawlik said. “Developing strategies for early identification, inpatient withdrawal management, and perioperative risk stratification may improve surgical outcomes, lower health care costs, and enhance patient care.”