title: High rate of thiamine deficiency among inpatients with cancer referred for psychiatric consultation: results of a single site prevalence study.
abstract: Thiamine deficiency (TD) is increasingly recognized in medically ill patients. The prevalence of TD among cancer patients is unknown. This study aims to characterize the prevalence of TD among inpatients with cancer.
  
  
  
  Retrospective chart review of patients admitted to a large cancer center who were referred for psychiatric consultation and whose serum thiamine concentration was measured. Patients with alcohol use were excluded.
  
  
  
  Among 217 patients with various cancer types, TD was found in 55.3%. Risk factors included fluorouracil-based chemotherapy, significant weight loss, and undergoing active cancer treatment. Almost all patients were normal weight, overweight, or obese, and few had concomitant vitamin B12 or folate deficiency. A total of 17.5% were receiving multivitamin supplementation. Nearly half (49.8%) did not receive empiric treatment with thiamine and among those who did, treatment delay occurred in the majority of cases (59.6%). Measurement of serum thiamine concentration preceded psychiatric consultation in only 10.6% of cases.
  
  
  
  Our findings suggest that TD is highly prevalent among inpatients with cancer, even among normal and overweight individuals, in the absence of other vitamin deficiencies, and while receiving multivitamin supplements. Several potential risk factors were identified, including active cancer treatment. Evaluation of TD was most commonly not initiated by oncologists. Failure to treat and treatment delay were common. Given these findings, oncologists must be vigilant about detecting TD among inpatients with cancer. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Psychiatry, Sunnybrook Health Sciences Center, Toronto, ON, Canada.
authors.forename: Elie
authors.identifier: 0000-0001-8717-8845
authors.initials: E
authors.lastname: Isenberg-Grzeda
authors.affiliation: Weill-Cornell Medical College, New York, NY, USA.
authors.forename: Megan Johnson
authors.initials: MJ
authors.lastname: Shen
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Yesne
authors.initials: Y
authors.lastname: Alici
authors.affiliation: Department of Information Systems, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wills
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Nelson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000150:complications / Q000523:psychology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013831:Thiamine / Q000097:blood*; D013832:Thiamine Deficiency / Q000097:blood / Q000175:diagnosis*; D015431:Weight Loss
chemical_list: D013831:Thiamine
keywords: Neoplasms; Nutritional status; Prevalence; Thiamine; Thiamine deficiency