择期全髋关节置换术中的酒精使用：风险还是获益？
Alcohol use in elective total hip arthroplasty: risk or benefit?
机构信息
Orthopaedic Institute at Mercy Hospital, 3659 S Miami Avenue, Suite 4008, Miami, FL 33133, USA.
出版信息
Clin Orthop Relat Res. 2013 Feb;471(2):504-9. doi: 10.1007/s11999-012-2540-z.
BACKGROUND
Excessive alcohol consumption has been associated with adverse health measures after elective surgery. The effects of low or moderate consumption remain unclear.
QUESTION/PURPOSES: We determined differences among patients with different consumption levels in (1) preoperative and postoperative patient-perceived outcomes and hip scores, (2) changes in those scores from preoperatively to postoperatively, (3) demographics and comorbidities, and (4) length of stay (LOS) and hospitalization charges.
METHODS
We retrospectively reviewed 191 patients (218 primary hips). Based on a self-administered consumption questionnaire, patients were stratified into three groups: (1) nondrinkers (n = 52), (2) occasional drinkers (n = 56), and (3) moderate drinkers (n = 17). Demographics, BMI, Charlson Comorbidity Index, and American Society of Anesthesiologists grade; preoperative and postoperative Quality of Well-being Scale, SF-36, WOMAC, Harris hip, and Merle d'Aubigné-Postel hip scores; and LOS and hospital charges were obtained and compared among groups adjusting for patient characteristics. Minimum followup was 1 year (mean, 3.5 years; range, 1-6 years).
RESULTS
Most abstainers were older, female, and Hispanic. Preoperatively, moderate drinkers had better WOMAC function and total scores and Harris hip scores. There were no differences postoperatively among groups. However, nondrinkers had greater improvement (preoperative to postoperative) in the WOMAC function, pain, and total scores. Compared to nondrinkers, moderate drinkers had a higher contribution margin and net income.
CONCLUSIONS
Alcohol consumption is more common among men and non-Hispanics. Moderate consumption was associated with better WOMAC and Harris hip scores. After surgery, abstainers achieved greater improvements in the WOMAC function, pain, and total scores.
LEVEL OF EVIDENCE
Level III, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.
背景
大量饮酒与择期手术后的健康状况不佳有关。低或中等饮酒量的影响仍不清楚。
问题/目的：我们确定了不同饮酒水平的患者在以下方面的差异：（1）术前和术后患者感知的结果和髋关节评分，（2）从术前到术后评分的变化，（3）人口统计学和合并症，以及（4）住院时间（LOS）和住院费用。
方法
我们回顾性地分析了 191 名患者（218 个原发性髋关节）。根据自我管理的饮酒问卷，患者分为三组：（1）不饮酒者（n=52），（2）偶尔饮酒者（n=56），和（3）中度饮酒者（n=17）。获取了人口统计学、BMI、Charlson 合并症指数和美国麻醉医师协会分级；术前和术后生活质量量表、SF-36、WOMAC、Harris 髋关节和 Merle d'Aubigné-Postel 髋关节评分；以及 LOS 和住院费用，并根据患者特征在组间进行比较。最低随访时间为 1 年（平均 3.5 年；范围 1-6 年）。
结果
大多数戒酒者年龄较大，为女性，且为西班牙裔。术前，中度饮酒者 WOMAC 功能和总分以及 Harris 髋关节评分更好。术后各组间无差异。然而，不饮酒者在 WOMAC 功能、疼痛和总分方面的改善更大。与不饮酒者相比，中度饮酒者的边际贡献和净收入更高。
结论
饮酒在男性和非西班牙裔人群中更为常见。中度饮酒与 WOMAC 和 Harris 髋关节评分更好相关。手术后，戒酒者在 WOMAC 功能、疼痛和总分方面取得了更大的改善。
证据水平
III 级，预后研究。有关证据水平的完整说明，请参见作者说明。
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