Alcohol Withdrawal Syndrome Tied to Higher Complications After Major Surgery

TUESDAY, Aug. 5, 2025 (HealthDay News) — Patients undergoing major surgery who experience alcohol withdrawal syndrome (AWS) and delirium tremens (DT) face significantly higher risks for complications, according to a study published online July 22 in the Journal of the American College of Surgeons.

Azza Sarfraz, M.B.B.S., from The Ohio State University in Columbus, and colleagues calculated the incidence and impact of AWS among patients undergoing major surgery. The analysis included data from about 3 million adult surgical patients identified from the National Inpatient Sample (2016 to 2019).

The researchers found that 0.5 percent of patients were diagnosed with AWS, including 0.2 percent with DT. Patients with AWS were more often younger (median age, 61 versus 67 years), predominantly male (83.7 versus 57.3 percent), and more likely to have Medicaid insurance (21.2 versus 8.2 percent). There was an independent association between AWS and an increased risk for postoperative complications (adjusted odds ratio [aOR], 1.37), particularly respiratory failure (aOR, 2.44) and sepsis (aOR, 1.61). Utilization was also higher among patients with AWS, including longer length of stay (median, 11 versus six days) and higher hospitalization costs ($44,300 versus $28,800), yielding an adjusted cost increase of $10,030 per patient. Mortality risk was higher with DT (aOR, 1.40), as was length of stay (+5.3 days).

“A patient recovering from major surgery shouldn’t also battle withdrawal,” Timothy Pawlik, M.D., Ph.D., M.P.H., also from Ohio State, said in a statement. “We can change this by addressing alcohol use before surgery and ensuring safer recovery environments.”

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