Alkol Tüketimine Bağlı Acil Servise Başvuran Hastalar ve Cerrahi Boyutu

Küresel düzeyde en yaygın kullanılan maddelerden biri olan alkol, bugün birçok hastalığın etiyolojisini oluşturmaktadır. Alkol tüketimine ilişkin veriler, gelecek yıllarda tüketimdeki olası hızlı artışın habercidir. Hastanelere yapılan başvuruların, tanısal işlemler ya da cerrahi geçiren hastaların klinik prognozunun önemli bir kısmını alkol tüketimine ilişkin sorunlar oluşturmaktadır. Etken maddenin, özellikle acil servislerde, perioperatif süreç yönetiminde ve sağlık bakım hizmetlerinde yarattığı hasta yükü önemli bir sorundur. Alkol organizma için toksik özellik gösterdiğinden, sağlık kuruluşlarına yapılan başvurularda alkollü olduğu tespit edilen bireylerin, tanı, tedavi ve değerlendirme süreçlerinde özel yaklaşım ve uygulamalara gereksinim vardır. Bu derleme, alkol/alkol tüketiminin organizma üzerindeki etkileri, bireylerin acil servis başvuruları ve perioperatif süreçlerine ilişkin dikkat edilmesi gerekenlere yönelik literatür verilerini incelemek amacıyla yazılmıştır.

Patients Presenting to the Emergency Department Due to Alcohol Consumption and its Surgical Dimension

Today, alcohol which is one of most commonly used substance on global level constitutes the etiology of many diseases. Data on alcohol consumption foreshadow the possible rapid increase in its consumption in the coming years. A significant part of the admissions to hospitals, and the clinical prognosis of patients who have undergone diagnostic or surgical processes consist of the problems aroused by alcohol consumption. The patient load created by this active substance especially in emergency services, perioperative process management and the healthcare services is an important problem. Because of that alcohol presents a toxic property, it is needed special approaches and practices in diagnosis, treatment and examination processes of individuals who are detected as drunk in the admissions to healthcare institutions. This compilation is written for the purpose of analyzing the literature data towards the effects of alcohol/alcohol consumption on human organism, and the points to take into consideration about the individuals’ admissions to emergency service and their perioperative processes.

___

  • 1. World Health Organization. Alcohol. https://www.who.int/health-topics/alcohol#tab=tab_1 (03 Ağustos 2020’de ulaşıldı).
  • 2. GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet 2018; 392(10152): 1015–1035.
  • 3. Rehm J, Gmel GE, Gmel G, et al. The relationship between different dimensions of alcohol use and the burden of disease—an update. Addiction 2017; 112(6): 968–1001.
  • 4. World Health Organization. Global Status Report on Alcohol and Health 2019. Geneva: WHO, 2019.
  • 5. Goel S, Sharma A, Garg A. Effect of alcohol consumption on cardiovascular health. Curr Cardiol Rep 2018; 20(4): 1-10.
  • 6. Polsky S, Akturk HK. Alcohol consumption, diabetes risk, and cardiovascular disease within diabetes. Curr Diab Rep 2017; 17(12): 1-12.
  • 7. Di Castelnuovo A, Costanzo S, Bagnardi V, et al. Alcohol dosing and total mortality in men and women an updated meta-analysis of 34 prospective studies. Arch Intern Med 2006; 166(22): 2437-2445.
  • 8. World Health Organization. Global Status Report On Alcohol and Health 2018. Geneva: WHO, 2018.
  • 9. Manthey J, Shield KD, Rylett M, et al. Global alcohol exposure between 1990 and 2017 and forecasts until 2030: a modelling study. Lancet 2019; 393(10190): 2493-2502.
  • 10. Sukumaran AB, Vijith D, Haran JC. Prevalence of alcohol use and the interventions needed among adults: a community study in a rural area in South India. J Family Med Prim Care 2020; 9(6): 2769–2773.
  • 11. Andersson LMC, Twum-Antwi A, Staland-Nyman C, Rm van Rooyen D. Prevalence and socioeconomic characteristics of alcohol disorders among men and women in the Eastern Cape Province, South Africa. Health Soc Care Community 2018 ; 26(1): e143-e153.
  • 12. Flor LS, Gakidou E. The burden of alcohol use: better data and strong policies towards a sustainable development. Lancet Public Health 2020; 5(1): e10-e11.
  • 13. Katikireddi, SV, Whitley E, Lewsey J, et al. Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data. Lancet Public Health 2017; 2(6): e267-e276.
  • 14. Eashwar VMA, Umadevi R, Gopalakrishnan S. Alcohol consumption in India– an epidemiological review. J Family Med Prim Care 2020; 9(1): 49–55.
  • 15. Koob GF. Theoretical frameworks and mechanistic aspects of alcohol addiction: alcohol addiction as a reward deficit disorder. Curr Top Behav Neurosci 2013; 13: 3-30.
  • 16. Pascual M, Baliño P, Aragón CMG, Guerri C. Cytokines and chemokines as biomarkers of ethanol-induced neuroinflammation and anxiety-related behavior: role of TLR4 and TLR2. Neuropharmacology 2015; 89: 352- 359.
  • 17. Leonard EA, Buckley T, Curtis K. Impact of alcohol on outcomes in hospitalized major trauma patients: a literature review. J Trauma Nurs 2016; 23(2): 103-114.
  • 18. Voıcu DF, Cıubara AB, Stan D, Cıubara A. Somatic complications of alcoholism in the surgical patient. BRAIN. Broad Research in Artificial Intelligence and Neuroscience 2020; 11(1): 78-89.
  • 19. Spies C, Tønnesen H, Andreasson S, et al. Perioperative morbidity and mortality in chronic alcoholic patients. Alcohol Clin Exp Res 2001; 25(5 Suppl ISBRA): 164S-170S.
  • 20. Kork F, Neumann T, Spies C. Perioperative management of patients with alcohol, tobacco and drug dependency. Curr Opin Anaesthesiol 2010; 23(3): 384-390.
  • 21. Çiftçi A, Durak VA, Aslan Ş. Acil servise travma nedeniyle başvuran hastalarda mortaliteye etki eden faktörlerin değerlendirilmesi. Anatolian Journal of Emergency Medicine 2020; 3(3): 76–80.
  • 22. Vardy J, Keliher T, Fisher J, et al. Quantifying alcohol-related emergency admissions in a UK tertiary referral hospital: a cross-sectional study of chronic alcohol dependency and acute alcohol intoxication. BMJ Open 2016; 6(6): e010005.
  • 23. Forson PK, Oduro G, Bonney J, et al. Emergency department admissions Kumasi, Ghana: prevalence of alcohol and substance use, and associated trauma. J Addict Dis 2020; 38(4): 520-528.
  • 24. Bilgin UE, Meral O, Aktaş EO, Kıyan S, Altuncı YA. 2011 yılında trafik kazası sonucu Ege Üniversitesi Hastanesi Acil Servisine başvuran hastaların adli tıbbi boyutuyla incelenmesi. Ege Tıp Dergisi 2013; 52(2): 93-99.
  • 25. Erdoğan Çetin Z, Teyin A, Birben B, Çetin B, Şahiner GG, Hamamcı M. Acil serviste düzenlenen adli raporların değerlendirilmesi. Bozok Tıp Derg 2018; 8(4): 34-40.
  • 26. Yaşar ZF, Büken E. Başkent Üniversitesi Hastanesine trafik kazası nedeniyle başvuran adli olguların incelenmesi. Adli Tıp Bülteni 2015; 20(3): 132-137.
  • 27. Mundenga MM, Sawe HR, Runyon MS, et al. The prevalence of alcohol and illicit drug use among injured patients presenting to the emergency department of a national hospital in Tanzania: a prospective cohort study. BMC Emerg Med 2019; 19(1): 15.
  • 28. Matar MM, Jewett B, Fakhry SM, et al. Identifying chronic heavy alcohol use in emergency general surgery patients: a pilot study. Trauma Surg Acute Care Open 2017; 2(1): 1-5.
  • 29. Ungur AL, Neumann T, Borchers F, Spies C. Perioperative management of alcohol withdrawal syndrome. Visc Med 2020; 36: 160–166.
  • 30. Hirugade ST, Kadole SB. Evaluation of alcoholism related admissions in the surgical ward: a retrospective study. International Journal of Scientific Research 2019; 8(12): 42-43.
  • 31. Svensen G, Kool B, Buller S. The burden of alcohol-related presentations to a busy urban New Zealand hospital emergency department. N Z Med J 2019; 132(1504): 56-66.
  • 32. Phillips T, Coulton S, Drummond C. Burden of alcohol disorders on emergency department attendances and hospital admissions in England. Alcohol Alcohol 2019; 54(5): 516–524.
  • 33. Taylor CL, Passmore N, Kilbane P, Davies R. Prospective study of alcohol-related admissions in an inner-city hospital. Lancet 1986; 2(8501): 265-268.
  • 34. Fabbri A, Marchesini G, Morselli-Labate AM, et al. Blood alcohol concentration and management of road trauma patients in the emergency department. J Trauma 2001; 50(3): 521-528.
  • 35. Spies CD, Rommelspacher H. Alcohol withdrawal in the surgical patient: prevention and treatment. Anesth Analg 1999; 88(4): 946–954.
  • 36. Mohseni S, Bellander BM, Riddez L, et al. Positive blood alcohol level in severe traumatic brain injury is associated with better long-term functional outcome. Brain Inj 2016; 30(10): 1256–1260.
  • 37. Levy RS, Hebert CK, Munn BG, Barrack RL. Drug and alcohol use in orthopedic trauma patients: a prospective study. J Orthop Trauma 1996; 10(1): 21-27.
  • 38. Soldi M, Mauthner O, Frei IA, Hasemann W. Experience of adult patients and professionals with a program for the prevention of alcohol withdrawal delirium in the acute care setting—a case study. Perspect Psychiatr Care 2021; 57(2): 726-733.
  • 39. Kaka AS, Zhao S, Ozer E, et al. Comparison of clinical outcomes following head and neck surgery among patients who contract to abstain from alcohol vs patients who abuse alcohol. JAMA Otolaryngol Head Neck Surg 2017; 143(12): 1181-1186.
  • 40. Fox CJ, Liu H, Kaye AD. The anesthetic implication of alcoholism. Int Anesthesiol Clin 2011; 49(1): 49-65.
  • 41. Chapman R, Plaat F. Alcohol and anaesthesia. Continuing Education in Anaesthesia Critical Care & Pain 2009; 9(1): 10–13.
  • 42. Blincoe T, Chambler D. Alcohol and anaesthesia. Br J Hosp Med (Lond) 2019; 80(8): 485.
  • 43. Eliasen M, Grønkjær M, Skov-Ettrup LS, et al. Preoperative alcohol consumption and postoperative complications: a systematic review and meta-analysis. Ann Surg 2013; 258(6): 930-942.
  • 44. Best MJ, Buller LT, Gosthe RG, et al. Alcohol misuse is an independent risk factor for poorer postoperative outcomes following primary total hip and total knee arthroplasty. J Arthroplasty 2015; 30(8): 1293-1298.
  • 45. Rotevatn TA, Bøggild H, Olesen CR, et al. Alcohol consumption and the risk of postoperative mortality and morbidity after primary hip or knee arthroplasty - a register-based cohort study. PLoS One 2017; 12(3): 1-16.
  • 46. Benson C, Weinberg J, Narsule CK, Brahmbhatt TS. A comparison of alcohol positive and alcohol negative trauma patients requiring an emergency laparotomy. Am J Emerg Med 2018; 36(7): 1139-1144.
  • 47. Francalanci C, Chiassai S, Ferrara G, et al. Scale for the measurement of attitudes towards alcohol. Alcohol Alcohol 2011; 46(2): 133–137.
  • 48. World Health Organizaton. The Alcohol Use Disorders Identification Test guidelines for use in primary care. Second Edition. Geneva: WHO, 2001.
  • 49. Bush K, Kivlahan DR, McDonell MS, et al. The AUDIT Alcohol Consumption Questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med 1998; 158(16): 1789–1795.
  • 50. Stockwell T, Murphy D, Hodgson R. The Severity of Alcohol Dependence Questionnaire: its use, reliability and validity. Br J Addict 1983;78(2): 145-155.
  • 51. Akyel B, Aldemir E, Ender Altıntoprak A. Alkol Bağımlılığı Şiddeti Ölçeği: Türkçe formunun geçerlik ve güvenirliği. Türk Psikiyatri Dergisi 2018; 29(3): 202-208.
  • 52. McLellan AT, Luborsky L, Woody GE, O'Brien CP. An improved diagnostic evaluation instrument for substance abuse patients. The Addiction Severity Index. J Nerv Ment Dis 1980; 168(1): 26-33.
  • 53. McLellan AT, Kushner H, Metzger D, et al. The fifth edition of the Addiction Severity Index. J Subst Abuse Treat 1992; 9(3):199-213.
  • 54. Demirbaş H, Ilhan İÖ, Beyatlı Doğan Y, Canatan A. Reliability and validity of the Turkish version of the Addiction Severity Index in male alcohol dependents. Noro Psikiyatr Ars 2014; 51(3): 216-221.
  • 55. Morean ME, Corbin WR, Treat TA. The Subjective Effects of Alcohol Scale: development and psychometric evaluation of a novel assessment tool for measuring subjective response to alcohol. Psychol Assess 2013; 25(3): 780-795.
  • 56. Morean ME, Corbin WR, Treat TA. The Anticipated Effects of Alcohol Scale: development and psychometric evaluation of a novel assessment tool for measuring alcohol expectancies. Psychol Assess 2012; 24(4): 1008- 1023.
  • 57. de Vargas D, Villar Luis MA. Development and validation of a scale of attitudes towards alcohol, alcoholism and alcoholics. Rev Lat Am Enfermagem 2008; 16(5): 895-902.
  • 58. Martin CS, Earleywine M, Musty RE, et al. Development and validation of the Biphasic Alcohol Effects Scale. Alcohol Clin Exp Res 1993; 17(1): 140-146.
  • 59. Rueger SY, King AC. Validation of the Brief Biphasic Alcohol Effects Scale (B-BAES). Alcohol Clin Exp Res 2013; 37(3): 470–476.
  • 60. Skinner HA, Allen BA. Alcohol dependence syndrome: measurement and validation. J Abnorm Psychol 1982; 91(3): 199–209.
  • 61. Flannery BA, Volpicelli JR, Pettinati HM. Psychometric properties of the Penn Alcohol Craving Scale. Alcohol Clin Exp Res 1999; 23(8): 1289-1295.
  • 62. Evren C, Flannery B, Çelik R, et al. Penn Alkol Aşerme Ölçeği (Paaö) Türkçe şeklinin yatarak tedavi gören erkek alkol bağımlısı hastalarda geçerliği ve güvenirliği. Bağımlılık Dergisi 2008; 9(3): 128-134.
  • 63. Gibbs LE. Validity and reliability of the Michigan Alcoholism Screening Test: a review. Drug Alcohol Depend 1983; 12(3): 279-285.
  • 64. Coskunol H, Bagdiken I, Sorias S, Saygılı R. Michigan Alkolizm Tarama Testinin geçerliliği. Ege Tıp Dergisi 1995; 34: 15-18.
  • 65. Butler SF, Budman SH, McGee MD, et al. Addiction severity assessment tool: development of a self-report measure for clients in substance abuse treatment. Drug Alcohol Depend 2005; 80(3): 349-360.
  • 66. Miller WR, Tonigan JS. Assessing drinkers’ motivation for change: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Psychology Addict Behav 1996; 10(2): 81-89.
  • 67. Zamorano DP, Lim PK, Haghverdian, BA, Gupta R. Perioperative management of the orthopaedic patient and alcohol use, abuse, and withdrawal. J Am Acad Orthop Surg 2019; 27(6): e249-e257.
  • 68. Forsberg L, Ekman S, Halldin J, Ronnberg S. Brief interventions for risk consumption of alcohol at an emergency surgical ward. Addict Behav 2000; 25(3): 471-475.
Bağımlılık Dergisi-Cover
  • ISSN: 1302-5570
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2000
  • Yayıncı: Galenos Yayınevi