Drug poisonings following bariatric surgery: Case series report
Bibliographic record
Abstract
Bariatric surgery alters gastrointestinal anatomy and physiology, which likely impacts upon oral medication absorption. Drug- and alcohol-related deaths in this population are being increasingly reported; however, toxicological detail is lacking. Using data reported to the National Programme on Substance Use Mortality, we identified 18 deaths in people who had previously undergone bariatric surgery. Opioids were detected in almost all cases and were frequently implicated in causing death. Multiple medications were detected at post-mortem in every case and often included medications that the deceased was not actively prescribed. Mental health conditions and chronic pain were commonly listed comorbidities and one-third of deaths were deemed suicide. Illicit drug and alcohol use was rare, highlighting a distinct vulnerability to prescription medication harms. Our findings emphasize a need to understand how bariatric surgery alters pharmacokinetics and for integrated, multidisciplinary aftercare, therapeutic drug monitoring and tailored education of safe medication use in bariatric surgery patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.007 | 0.005 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
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 source (direct Gemma or distilled Codex), 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".