Anaemia rates rise 10 years after bariatric surgery

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Researchers found a high rate of anaemia 10 years after patients received Roux-en-Y gastric bypass (RYGB), suggesting that long-term follow-up with a bariatric specialist is important to lessen the risk for anaemia, according to a study.

Potential adverse outcomes of RYGB, such as mineral and/or vitamin deficiency, are well documented. Dr Dan Eisenberg, of the Palo Alto Veterans Affairs Health Care System, Palo Alto, and Stanford University and colleagues examined the prevalence of anaemia 10 years after RYGB and assessed whether post-operative bariatric follow-up influences rates of anaemia. The study included 74 patients (78% men; average age, 51 years) who underwent RYGB at a single Veterans Affairs Medical Centre.

The average rate of pre-operative anaemia was 20%; the rate increased 10 years after RYGB to 47%. At 10 years after RYGB, the anaemia rate in the group without bariatric specialist follow-up increased to 57%, from 22% before surgery. The rate of anaemia in the group with bariatric specialist follow-up did not increase significantly after 10 years (19% vs 13%). Compared with patients with bariatric specialist follow-up, patients without bariatric specialist follow-up had significantly higher odds of anaemia at 10 years after adjusting for preoperative anaemia.

The major limitation of this study was the size of the group with bariatric specialist follow-up, which may be too small to identify a significant difference in the 10-year anaemia rates compared with pre-operative rates.

“Our study suggests that follow-up with bariatric specialists more than 5 years after surgery, rather than with specialists with no bariatric expertise, can decrease long-term anemia risk. This finding may demonstrate the bariatric specialist’s specific understanding of the long-term risk for nutritional deficiency after RYGB and the importance of vitamin and mineral supplementation,” the authors write.

Obesity is common among US veterans and Roux-en-Y gastric bypass (RYGB) is the criterion standard operation for weight loss. Potential adverse outcomes, such as mineral and/or vitamin deficiency, are well documented, but few studies have described long-term outcomes in the veteran population. This study evaluates the prevalence of anemia 10 years after RYGB and assesses whether postoperative bariatric follow-up influences rates of anemia.

Gao Linda Chen, Eric Kubat, Dan Eisenberg

JAMA material
JAMA Surgery research letter abstract

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