Alcohol use-specific treatment initiation among patients undergoing surgical procedures: A retrospective cohort analysis.

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.