Psychosocial factors associated with a positive phosphatidylethanol test during the preoperative evaluation for metabolic and bariatric surgery.

BACKGROUND

Patients who undergo metabolic and bariatric surgery (MBS) are at an increased risk for an alcohol use disorder. Preoperative alcohol use is associated with increased postoperative risk, yet patients under-report their alcohol use during the routine psychosocial evaluation. This results in challenges to accurately identify individuals at risk for postoperative alcohol use disorder.

OBJECTIVE

This study investigated whether there are clinical characteristics associated with objective measurement of alcohol use to help guide preoperative assessment.

SETTING

Single healthcare system.

METHODS

Retrospective medical record reviews were conducted on 85 patients who completed a preoperative psychosocial evaluation and phosphatidylethanol (PEth) testing prior to MBS. Patient demographic and clinical characteristics were collected from the preoperative psychosocial evaluation.

RESULTS

Black individuals (37.7%) were more likely to have a positive PEth test compared to White individuals (13.8%, P = .02). Individuals with a positive PEth test had significantly lower depressive symptoms than those with a negative PEth test (P = .03). No other demographic or clinical characteristics were associated with PEth test results.

CONCLUSIONS

Few variables were associated with a positive PEth test, and the value of the statistical differences may not be clinically meaningful. As such, it is difficult to use clinical characteristics to assist with identification of individuals with regular alcohol use at the preoperative assessment. There may be benefits to routine use of objective alcohol measurement, such as PEth testing, for patients pursuing MBS to identify individuals who are engaging in regular or heavy alcohol use at the time of the preoperative evaluation.