Background

Patients who undergo metabolic and bariatric surgery (MBS) are prone to nutritional deficiencies. The varying degree of vitamin malabsorption among MBS patients may increase risk for Thiamine(vitamin B1) deficiency and the associated sequalae of Wernicke’s-Korsakoff encephalopathy(WE). Case studies have noted WE among MBS patients but research using a nationwide dataset has not been performed. We sought to determine the incidence and association of MBS with WE.

Methods

Using the National Inpatient Sample (NIS), we identified adult patients (≥35 years-old) with a history of bariatric surgery between 2016-2019. We used a Pearson χ2 analysis, analysis of variance and multivariable regression analyses to analyze odds and associations for the primary outcome: WE; and secondary outcomes: WE within MBS subpopulation. MBS was identified using International Classification of Diseases version-10 Clinical Modification code Z98.84; non-alcoholic WE were identified using the codes E51.2 and F04. STATA/MP was used for analyses.

Results

There were 982,220 in the NIS database with a history of MBS. The incidence of WE were higher for those with MBS(0.01379%) compared to non-MBS(0.0074%) (p<0.001). MBS was associated with higher odds of WE compared to non-MBS patients (aOR: 1.86, [1.29-2.68], p<0.001). Within the MBS subpopulation, alcohol abuse was associated with a higher odds of WE compared to non-alcoholics (aOR: 9.09, [3.10 - 26.62], p<0.001)(Table 1).

Conclusions

There was a nearly 2 times increased risk of nonalcoholic WE in patients with history of bariatric surgery. There is an even higher increased risk among those patients with MBS and a history of alcohol abuse.