Rebecca Angus

Reviewing and analysing the relationship between alcohol consumption and postoperative outcomes in gastrointestinal surgery.

Medical Student Essay Prize Winner

“A systematic review and meta-analysis of the relationship between alcohol consumption and postoperative outcomes in gastrointestinal surgery.”

Within her project, Ms Angus highlights how alcohol misuse is a huge problem worldwide, accounting for over 3 million global deaths annually. Also, this has been exacerbated during and leading on from the Covid-19 pandemic. Alcohol misuse can increase the risk of gastrointestinal (GI) diseases which results in the need for GI surgery. In order to improve patient care and optimise overall recovery, Ms Angus describes that it is vitally important to understand the association between alcohol consumption and surgical outcomes.

Ms Angus explains:

Our meta-analysis examined 13 relevant papers across a cohort of 686181 patients, divided into those who drank alcohol or not pre operation. End points were a thirty day post operative mortality outcome and we also looked at secondary outcomes including surgical infections and anastomotic leak.

The main finding of our systematic review meta-analysis was that high preoperative alcohol consumption was associated with a 1.56-fold increase in the odds of 30-day mortality in individuals undergoing GI surgery compared to those who did not consume alcohol. This effect was more pronounced in those undergoing colorectal surgery which saw a greater increase— 2.6-fold – compared to those undergoing upper GI/ Hepato-Pancreato-Biliary surgery, with a 1.3-fold increase. Additionally, we found an increase in risk of anastomotic leak and surgical site infections in heavy drinkers compared to those who do not drink.

Her findings significantly contribute to the growing body of evidence showing the detrimental impact of alcohol consumption on postoperative outcomes. This highlights the urgent need to reduce alcohol consumption to mitigate mortality risks in surgical patients.

Why did you choose this project?

Rebecca (second left) with (from left to right) Dr Riadh Jazrawi of Dr Falk, Ho Kiu Giselle Ngan and Prof Andy Veitch, BSG President 2022-2024

“I wanted to take on this project because I recognised the effect that alcohol misuse has as a modifiable risk factor in elective surgeries. This topic also resonated with me personally as I have a real interest in addiction medicine.

Being involved in this research project as a third-year medical student opened my eyes to the world of research, something that I had not previously recognised. I have gained an appreciation for the power of evidence-based medicine in guiding clinical decisions and improving patient care.”

Research used to feel daunting but through completing this project and receiving recognition for it has instilled a newfound confidence and enthusiasm in me. I am very grateful for the knowledge and guidance I received from Nottingham University, particularly David Humes, Alife Adiamah and Tjunwei Leow who were all so helpful and generous with their time. I really enjoyed the opportunity to learn about matters relating to gastro – intestinal surgery and the skills I’ve acquired will equip me well for future research.

- Rebecca Angus

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