Fox W, Borgert A, Rasmussen C, Kallies K, Klas P, Kothari S. Long-term micronutrient surveillance after gastric bypass surgery in an integrated healthcare system.
Surg Obes Relat Dis 2019;
15:389-395. [PMID:
30709752 DOI:
10.1016/j.soard.2018.12.029]
[Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/07/2018] [Accepted: 12/29/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND
The number of patients undergoing bariatric surgery in the United States is growing. While gastric bypass surgery is an important tool in the management of obesity, it requires lifelong metabolic monitoring and medical management. Data describing compliance with recommended laboratory follow-up are limited, particularly in long-term and primary care settings.
OBJECTIVES
To evaluate postoperative follow-up laboratory testing for patients after laparoscopic Roux-en-Y gastric bypass (LRYGB).
SETTING
Academic-affiliated community hospital.
METHODS
A review of patients who underwent LRYGB from 2001 to 2016 was performed. The location of patients' follow-up care and compliance with recommended laboratory testing were determined from patient records. Compliance was analyzed at 1-year intervals.
RESULTS
One thousand four hundred ninety patients underwent LRYGB. Five years after their surgical date, patients were more likely to follow-up with primary care than bariatric surgery clinic (369 versus 159 patients). At 5 years postoperative, 82%, 85%, and 68% of patients that followed-up with primary care did not have a vitamin D, parathyroid hormone, or vitamin B12 test, respectively. Patients that followed-up in bariatric clinic were slightly more likely to have recommended labs completed. At 5 years postprocedure, 81%, 55%, and 48% did not have a vitamin D, parathyroid hormone, or vitamin B12 test, respectively.
CONCLUSION
Most patients do not have the recommended laboratory testing completed, regardless of where their follow-up care occurred. This study identified a gap in long-term postoperative care for patients who have undergone gastric bypass surgery. Further studies will be necessary to develop interventions aimed at improving adherence to recommended monitoring after LRYGB.
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