Objective: To evaluate the feasibility of Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screening among surgical inpatients following hospital-wide implementation of a quality improvement initiative. Background: Risky alcohol use increases postoperative complications, yet alcohol screening for surgery remains inconsistently applied. As a brief, validated screening tool, the AUDIT-C may improve risk assessment and guide timely intervention, but its adoption in surgical settings is understudied. Methods: We retrospectively analyzed electronic health record data from inpatient surgical admissions between April 2021 and September 2023. The primary outcome was completion of a valid AUDIT-C score during admission. Scores were categorized as no use (0), low-risk (1–4), moderate-risk (5–8), and high-risk (9–12). Multivariable logistic regression assessed independent associations with AUDIT-C screening completion. Results: Among 30,714 encounters, 9540 (31.1%) had a completed AUDIT-C score. Screening completion varied by surgical service (15.2%–52.4%) and was higher in emergent (51.7%) and urgent (48.4%) cases than elective (29.1%) cases. The 3 most frequently performed procedures screened 53.8% (cesarean), 42.8% (free flap), and 11.6% (aortic valve) of patients. In multivariable models, emergent case status marginal effect (ME): 0.14, urgent case status (ME: 0.09), and Medicare insurance (ME: 0.03) were independently associated with higher odds of screening completion. Among those screened, 6.5% were classified as moderate- or high-risk. Conclusions: Perioperative alcohol screening using AUDIT-C is feasible but inconsistently implemented. System-wide integration could support identification of at-risk patients and improve perioperative outcomes.
Chen et al. (Thu,) studied this question.