Alcoholics at risk of infection after heart surgery

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Patients with long-standing alcoholism who undergo heart surgery are four times more likely to acquire an infection after the operation than their non-alcoholic peers, according to a new report. The results suggest that the elevated risk may be associated with increased levels of two immune factors—interleukin-10, an anti-inflammation protein, and cortisol, a steroid hormone.

“A key consideration here is that long-term alcoholics have pretty well-defined immune alterations prior to clinically evident infections,” lead author Dr. Michael Sander, from University Hospital Charite in Berlin, said in a statement.

“We believe that these alterations might be responsible for the postoperative increased infection rate observed in our study and in others,” Sander added.

The new study, which is reported in the September issue of Alcoholism: Clinical & Experimental Research, involved a comparison of 10 alcoholics who underwent elective cardiac surgery with 34 non-alcoholic patients.

Blood samples were obtained at several points before and after surgery to assess levels of IL-10, cortisol, and other immune factors, the report indicates.

As noted, compared with the non-alcoholic group, the alcoholic group was at heightened risk for postoperative infections. In addition, alcoholic patients had longer intensive care unit (ICU) stays and were slower to wean off mechanical ventilation.

Moreover, the alcoholic group also displayed increased levels of IL-10 and cortisol postoperatively. In fact, elevated IL-10 levels were predictive of postoperative infections, the report indicates.

Sander and colleagues think it’s worth investigating whether treatments that modulate the immune system given before and during surgery may help decrease the infection rate as well as the lengthy ICU stay among alcoholic patients undergoing heart surgery.

SOURCE: Alcoholism: Clinical and Experimental Research, September 2005.

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