Aasheim listed risk factors for Wernicke's encephalopathy in a patient undergoing bariatric surgery. Many of these risk factors apply to any surgical patient. The author is from the University of Oslo in Norway.

Risk factors for thiamine deficiency in a surgical patient:

(1) chronic alcoholic

(2) diet deficient in thiamine prior to surgery

(3) persistent vomiting (from bowel obstruction or other cause)

(4) diet deficient in thiamine after surgery


Depletion of the body's thiamine stores can occur relatively quickly (2-3 weeks, sooner if stores low before surgery) if no thiamine is administered.


Factors contributing to development of Wernicke's encephalopathy:

(1) glucose loading without thiamine

(2) parenteral nutrition without thiamine


Thiamine deficiency in a surgical patient may be present for some time before it is eventually recognized. Prevention and active surveillance can minimize the risk of disabling complications.

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