Highlights
- •Pre-operative and post-operative nutritional deficiencies (NDs) diagnoses have increased since 2006
- •The most common 3-year postoperative NDs were anemia, vitamin D deficiency, protein malnutrition, and vitamin B12 deficiency
- •RYGB and SG were associated with two- to three-fold odds of developing postoperative NDs compared to LAGB, independent of baseline ND status
Abstract
Background
Bariatric surgery (BS) can lead to postoperative nutritional deficiencies (NDs) due
to restrictive and malabsorptive mechanisms, but there is limited literature quantifying
NDs’ prevalence over time and their predictors among patients undergoing BS.
Objective
To characterize time trends and predictors of postoperative NDs.
Setting
This retrospective cohort study used the U.S. IBM MarketScan commercial claims database
(2005–2019) to include adults who underwent BS with continuous enrollment.
Methods
BS included Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), adjustable gastric
band (AGB), and biliopancreatic diversion with duodenal switch. NDs included protein
malnutrition, deficiencies in vitamins D and B12, and anemia that may be related to
NDs. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence
intervals (CIs) of NDs across BS types after adjusting for other patient factors.
Results
Within 83,635 patients (mean age [SD], 44.5 [9.5] yr; 78% female patients), 38.7%,
32.9%, and 28% underwent RYGB, SG, and AGB, respectively. Age-adjusted prevalence
of any NDs within 1, 2, and 3 years after BS ranged from 23%, 34%, and 42%, respectively
(in 2006) to 44%, 54%, and 61%, respectively (in 2016). Relative to AGB group, the
adjusted OR of any 3-year postoperative NDs was 3.00 (95% CI, 2.89–3.11) for the RYGB
group and 2.42 (95% CI, 2.33–2.51) for the SG group.
Conclusions
RYGB and SG were associated with 2.4- to 3.0-fold odds of developing 3-year postoperative
NDs compared with AGB, independent of baseline ND status. Pre- and postoperative nutritional
assessment are recommended for all patients undergoing BS to optimize postoperative
outcomes.
Keywords
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Article info
Publication history
Published online: February 22, 2023
Accepted:
February 15,
2023
Received:
September 17,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
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