PDF(Pubmed)
Abstract：
BACKGROUND: Vitamin B1 (thiamine) deficiency (TD) after metabolic and bariatric surgery (MBS) is often insidious and, if unrecognized, can lead to irreversible damage or death. As TD symptoms are vague and overlap with other disorders, we aim to identify predictors of recurrent TD and failure to collect B1 labs.
METHODS: We analyzed a large sample of data from patients with MBS (n = 878) to identify potential predictors of TD risk. We modeled recurrent TD and failure to collect B1 labs using classical statistical and machine learning (ML) techniques.
RESULTS: We identified clusters of labs associated with increased risk of recurrent TD: micronutrient deficiencies, abnormal blood indices, malnutrition, and fluctuating electrolyte levels (aIRR range: 1.62-4.68). Additionally, demographic variables associated with lower socioeconomic status were predictive of recurrent TD. ML models predicting characteristics associated with failure to collect B1 labs achieved 75-81% accuracy, indicating that clinicians may fail to match symptoms with the underlying condition.
CONCLUSIONS: Our analysis suggests that both clinical and social factors can increase the risk of life-threatening TD episodes in some MBS patients. Identifying these indicators can help with diagnosis and treatment.
METHODS: We analyzed a large sample of data from patients with MBS (n = 878) to identify potential predictors of TD risk. We modeled recurrent TD and failure to collect B1 labs using classical statistical and machine learning (ML) techniques.
RESULTS: We identified clusters of labs associated with increased risk of recurrent TD: micronutrient deficiencies, abnormal blood indices, malnutrition, and fluctuating electrolyte levels (aIRR range: 1.62-4.68). Additionally, demographic variables associated with lower socioeconomic status were predictive of recurrent TD. ML models predicting characteristics associated with failure to collect B1 labs achieved 75-81% accuracy, indicating that clinicians may fail to match symptoms with the underlying condition.
CONCLUSIONS: Our analysis suggests that both clinical and social factors can increase the risk of life-threatening TD episodes in some MBS patients. Identifying these indicators can help with diagnosis and treatment.
摘要：
背景：代谢和减肥手术（MBS）后维生素B1（硫胺素）缺乏症（TD）通常是阴险的，如果无法识别，会导致不可逆转的伤害或死亡。由于TD症状模糊且与其他疾病重叠，我们的目标是确定复发TD和未能收集B1实验室的预测因素。
方法：我们分析了来自MBS患者（n=878）的大样本数据，以确定TD风险的潜在预测因子。我们使用经典的统计和机器学习（ML）技术对递归TD和未能收集B1实验室进行建模。
结果：我们确定了与复发性TD风险增加相关的实验室集群：微量营养素缺乏，血液指标异常,营养不良,和波动的电解质水平（aIRR范围：1.62-4.68）。此外,与较低社会经济地位相关的人口统计学变量是TD复发的预测因素.ML模型预测与未能收集B1实验室相关的特征，准确率达到75-81%，这表明临床医生可能无法将症状与潜在疾病相匹配。
结论：我们的分析表明，在某些MBS患者中，临床和社会因素都会增加危及生命的TD发作的风险。识别这些指标可以帮助诊断和治疗。
方法：我们分析了来自MBS患者（n=878）的大样本数据，以确定TD风险的潜在预测因子。我们使用经典的统计和机器学习（ML）技术对递归TD和未能收集B1实验室进行建模。
结果：我们确定了与复发性TD风险增加相关的实验室集群：微量营养素缺乏，血液指标异常,营养不良,和波动的电解质水平（aIRR范围：1.62-4.68）。此外,与较低社会经济地位相关的人口统计学变量是TD复发的预测因素.ML模型预测与未能收集B1实验室相关的特征，准确率达到75-81%，这表明临床医生可能无法将症状与潜在疾病相匹配。
结论：我们的分析表明，在某些MBS患者中，临床和社会因素都会增加危及生命的TD发作的风险。识别这些指标可以帮助诊断和治疗。
