Clinical and Psychometric Predictors of a Positive Alcohol Use Disorder Screen after Roux-en-Y Gastric Bypass: A...

Area of Science:

• Bariatric Surgery Outcomes
• Alcohol Use Disorder Screening
• Clinical Predictors

Background:

• Alcohol use disorder (AUD) post-bariatric surgery is under-detected due to reliance on self-report screening.
• Identifying reliable predictors is crucial for early detection and intervention.

Purpose of the Study:

• Identify clinical and psychometric predictors of positive alcohol screening post-bariatric surgery.
• Develop a simple risk-stratification model for AUD.
• Evaluate the utility of gamma-glutamyl transferase (GGT) in AUD detection.

Main Methods:

• Cross-sectional analysis of 130 Roux-en-Y gastric bypass (RYGB) patients.
• Utilized CAGE and AUDIT questionnaires for alcohol screening.
• Logistic regression and bootstrap resampling identified predictors.
• Exploratory analysis of GGT levels and longitudinal trajectories.

Main Results:

• 24.6% of patients screened positive for AUD.
• Male sex (OR 5.3) and paternal alcohol use (OR 5.5) were independent predictors.
• A two-variable risk model showed good performance (c-index 0.71) but requires validation.
• GGT levels were higher in screen-positive patients (median 31 vs. 15.5 U/L) but not statistically significant after FDR correction and within reference ranges.

Conclusions:

• Male sex and paternal alcohol use are key predictors for AUD screening post-bariatric surgery.
• A simple risk-stratification tool can guide targeted screening.
• GGT is not a reliable individual-level marker for AUD post-surgery and cannot replace psychometric screening.