This study aims to see if there's a link between a substance called phosphatidylethanol (PEth) and how patients who have surgery at University Hospitals do after surgery. PEth levels reflect the amount of alcohol use by someone over the past few weeks. This study is checking PEth levels on all patients who are planned to stay in the hospital for three or more days after surgery regardless if they drink alcohol. Specifically, it will look at if PEth levels are connected to problems that might come up during and after surgery, like confusion, lung or heart issues, needing blood transfusions, infections, unexpected intensive care unit (ICU) stays, and longer hospital stays. While there are reports of moderate alcohol consumption being good for the heart, there are other data that alcohol consumption can be harmful. Since there's not much information on how drinking alcohol affects health outcomes during and after surgery, especially for patients who are planned to be admitted to the hospital ward or ICU after surgery, this study will hopefully see if PEth levels before surgery can predict how patients do after the surgery.

The inclusion criteria to only include patients who consume alcoholic beverages was an IRB approved modification after already recruiting 1/3 of patients.

Inclusion Criteria:

• 1. Age range: 21-79
• 2. Patients undergoing elective surgery at UHCMC with planned ICU admission
• 3. Patients undergoing elective surgery at UHCMC with expected in-hospital admission for three or more days
• 4. Only patients who consume alcoholic beverages on a regular basis.

Exclusion Criteria:

• 1. Patients undergoing same day outpatient surgeries or expected to be admitted less than three days post-operatively
• 2. Subjects who have received a blood transfusion within the past month before surgery
• 3. Pregnant subjects

Patients undergoing elective surgery at UHCMC.