Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 8/2018

01-08-2018 | Original Contributions

Anemia and Bariatric Surgery: Results of a National French Survey on Administrative Data of 306,298 Consecutive Patients Between 2008 and 2016

Authors: Laurent Bailly, Luigi Schiavo, Lionel Sebastianelli, Roxane Fabre, Christian Pradier, Antonio Iannelli

Published in: Obesity Surgery | Issue 8/2018

Login to get access

Abstract

Background

Bariatric surgery (BS) has grown exponentially in France, and long-term anemia due to micronutrient deficiencies has become common.

Objectives

The objective of this study was to assess the long-term risk of anemia after BS and to investigate the factors associated with the occurrence of this complication.

Materials and Methods

Data from the French National Health Service database on patients who had undergone gastric bypass (GB), sleeve gastrectomy (SG), or adjustable gastric banding (AGB), between 2008 and 2016 were extracted. Only patients with a primary intervention were considered.

Results

Data from 306,298 patients (143.733 SG, 79.188 GB, and 36.413 AGB) were analyzed. Overall, 12.930 of them (5.0%) had a diagnosis of anemia due to micronutrient deficiencies as main diagnosis or related diagnosis at time of a hospital stay between 2008 and 2016. In multivariate analysis, GB surgery, female gender, age younger than 52 years, and 25-OH vitamin D deficiency were positively associated with the occurrence of anemia whereas hospital procedural volume was negatively associated. The risk to be diagnosed with anemia after BS was 13.0% after a GB, 5.6% after a SG and 4.0% after an AGB (Log-rank p < 0.0001). The hazard ratio for anemia after GB compared to SG was 2.0 (95% CI 1.9–2.1), adjusted for age and gender.

Conclusion

In France, between 2008 and 2016, 5% of patients had anemia after BS. The risk to develop anemia was 2-fold higher after a GB than after a SG. Young women should be particularly aware of this long-term risk.
Literature
1.
Sjöström L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56–65.CrossRefPubMed
2.
Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.CrossRefPubMedPubMedCentral
3.
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.CrossRefPubMed
4.
Lazzati A, Audureau E, Hemery F, et al. Reduction in early mortality outcomes after bariatric surgery in France between 2007 and 2012: a nationwide study of 133,000 obese patients. Surgery. 2016 Feb;159(2):467–74.CrossRefPubMed
5.
Malinowski SS. Nutritional and metabolic complications of bariatric surgery. Am J Med Sci. 2006;331(4):219–25.CrossRefPubMed
6.
Hammer HF. Medical complications of bariatric surgery: focus on malabsorption and dumping syndrome. Dig Dis Basel Switz. 2012;30(2):182–6.CrossRef
7.
8.
Thereaux J, Lesuffleur T, Païta M, et al. Long-term follow-up after bariatric surgery in a national cohort. Br J Surg. 2017;104(10):1362–71.CrossRefPubMed
9.
Kwon Y, Kim HJ, Lo Menzo E, et al. Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass: a meta-analysis. Surg Obes Relat Dis. 2014;10(4):589–97.CrossRefPubMed
10.
Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after roux-en-Y gastric bypass? J Gastrointest Surg Off J Soc Surg Aliment Tract. 1998;2(5):436–42.CrossRef
11.
12.
Quan H, Sundararajan V, Halfon P, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43(11):1130–9.CrossRefPubMed
13.
Knight T, D’Sylva L, Moore B, et al. Burden of iron deficiency anemia in a bariatric surgery population in the United States. J Manag Care Spec Pharm. 2015;21(10):946–54.CrossRefPubMed
14.
Mckinlay SM, Brambilla DJ, Posner JG. “Reprint of” the normal menopause transition. Maturitas. 2008;61(1):4–16.CrossRefPubMed
15.
Caron M, Hould FS, Lescelleur O, et al. Long-term nutritional impact of sleeve gastrectomy. Surg Obes Relat Dis. 2017;13(10):1664–73.CrossRefPubMed
16.
Karefylakis C, Näslund I, Edholm D, et al. Prevalence of anemia and related deficiencies 10 years after gastric bypass—a retrospective study. Obes Surg. 2015;25(6):1019–23.CrossRefPubMed
17.
18.
Salgado Jr W, Modotti C, Nonino CB, et al. Anemia and iron deficiency before and after bariatric surgery. Surg Obes Relat Dis. 2014;10(1):49–54.CrossRefPubMed
19.
20.
Parrott J, Frank L, Rabena R, et al. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surg Obes Relat Dis. 2017;13(5):727–41.CrossRefPubMed
21.
Keith CJ, Gullick AA, Feng K, et al. Predictive factors of weight regain following laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2017:1–7.
22.
Shantavasinkul PC, Omotosho P, Corsino L, et al. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2016;12(9):1640–5.CrossRefPubMed
23.
Baldridge AS, Pacheco JA, Aufox SA, et al. Factors associated with long-term weight loss following bariatric surgery using 2 methods for repeated measures analysis. Am J Epidemiol. 2015;182(3):235–43.CrossRefPubMedPubMedCentral
24.
25.
Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity. 2013;21(S1).
Metadata
Title
Anemia and Bariatric Surgery: Results of a National French Survey on Administrative Data of 306,298 Consecutive Patients Between 2008 and 2016
Authors
Laurent Bailly
Luigi Schiavo
Lionel Sebastianelli
Roxane Fabre
Christian Pradier
Antonio Iannelli
Publication date
01-08-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 8/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3143-x

Other articles of this Issue 8/2018

Obesity Surgery 8/2018 Go to the issue

Original Contributions

Displacement of the Intragastric Balloon from the Fundus to the Antrum Results in Enhanced Weight Loss

Letter to the Editor

Comments on “Challenges in Transition of Care for Pediatric Patients after Weight-Reduction Surgery: a Systematic Review and Recommendations for Comprehensive Care”

Original Contributions

Attrition after Acceptance onto a Publicly Funded Bariatric Surgery Program

Original Contributions

Efficacy of Postoperative Upper Gastrointestinal Series (UGI) and Computed Tomography (CT) Scan in Bariatric Surgery: a Meta-analysis on 7516 Patients

Original Contributions

Variation in Exhaled Acetone and Other Ketones in Patients Undergoing Bariatric Surgery: a Prospective Cross-sectional Study

Original Contributions

Trends in BMI, Glycemic Control and Obesity-Associated Comorbidities After Explantation of the Duodenal-Jejunal Bypass Liner (DJBL)