Higher pre-operative non-invasive fibrosis scores are not associated with surgical outcomes in patients with MASLD undergoing metabolic and bariatric surgery
Bibliographic record
Abstract
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of cirrhosis in Canada. Metabolic and bariatric surgery (MBS) leads to histologic improvement in patients with MASLD and obesity; however, patients with advanced fibrosis may be at risk for decompensation in liver function following MBS. There are currently no Canadian data evaluating the association between pre-operative advanced fibrosis and post-operative complications among patients with obesity undergoing MBS. Methods: We conducted a single-centre retrospective cohort study of individuals undergoing primary MBS (Roux-en-Y gastric bypass and sleeve gastrectomy) between September 2016 and August 2021. The primary exposure was pre-operative NAFLD (non-alcoholic fatty liver disease) fibrosis score (NFS). Outcomes of interest included post-operative complications and health care utilization at 30 and 90 days, and weight loss at 30 days post-operatively. Results: After exclusions, 204 patients who received MBS and had the data required to calculate NFS were included. The median age was 46 years (interquartile range 38-55 years) and 181 (89%) were female. A total of 55 (27%) patients had NFS, suggesting advanced fibrosis. There was no significant difference in 30- or 90-day complications and health care utilization rates in patients with higher NFS. Conclusions: Patients undergoing MBS have a high prevalence of steatosis and advanced fibrosis based on the NFS. Our data suggest that higher NFS is not associated with higher short-term post-operative complications in patients undergoing MBS. Further work needs to be done to determine the optimal method of screening for advanced liver disease in patients living with severe obesity.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".