Risk of thiamine deficiency and Wernicke’s encephalopathy after gastrointestinal surgery for cancer
Reviewer: Alan R. Gaby, MD
Author: Restivo A, et al
Reference: Risk of thiamine deficiency and Wernicke’s encephalopathy after gastrointestinal surgery for cancer. Support Care Cancer 2016;24:77-82.
Design: Prospective study
Participants: Forty-five patients who underwent gastrointestinal surgery for cancer.
Study Medication and Dosage: None
Primary Outcome Measures: The development of signs of Wernicke’s encephalopathy, which is caused by severe thiamine deficiency.
Key Findings: At the time of hospital discharge, 2 patients (4.4%) had signs of Wernicke’s encephalopathy. At 6 months, 21 patients were interviewed, of whom 90.4 % had signs of Wernicke’s encephalopathy.
Practice Implications: Severe thiamine deficiency, if not detected and treated in a timely fashion, can lead to permanent neurological damage. The results of the present study demonstrate that patients who have undergone gastrointestinal surgery for cancer are at high risk of developing severe thiamine deficiency. Thiamine deficiency presumably resulted from a combination of cancer-related malnutrition and decreased food intake secondary to gastrectomy. Patients who have undergone gastrointestinal surgery for cancer should receive prophylactic thiamine supplementation.