Nutrient Deficiency 10 Years Following Roux-en-Y Gastric Bypass: Who’s Responsible? View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-05

AUTHORS

J. Hunter Mehaffey, Rachel L. Mehaffey, Mathew G. Mullen, Florence E. Turrentine, Steven K. Malin, Bruce Schirmer, Andrew M. Wolf, Peter T. Hallowell

ABSTRACT

OBJECTIVE(S): Monitoring and prevention of long-term nutrient deficiency after laparoscopic Roux-en-Y gastric bypass (LRYGB) remains ill defined due to limited surgical follow-up after bariatric surgery. This study compared nutrient supplementation as well as surgeon and primary care physician (PCP) follow-up between patients with short-term versus long-term follow-up. METHODS: All patients undergoing LRYGB at a single institution in 2004 (long-term group, n = 281) and 2012-2013 (short-term group, n = 149) were evaluated. Prospectively collected database, electronic medical record (EMR) review and telephone survey were used to obtained follow-up for both cohorts. Multivariate logistic regression was used to assess factors independently predicting multivitamin use. RESULTS: Complete follow-up was achieved in 172 (61 %) long-term and 107 (72 %) short-term patients. We demonstrate a significant difference (p < 0.0001) in time since last surgeon follow-up (13.3 ± 7.8 vs 86.9 ± 39.9 months) for the long-term group with no difference in PCP follow-up, (3.1 ± 4.3 vs 3.7 ± 3.4). Nutrient supplementation was higher in the short-term group, including multivitamin (70.3 vs 58.9 %, p < 0.05), iron (84.2 vs 67.1 %, p = 0.02), and calcium (49.5 vs 32.9 %, p = 0.01). After adjusting for interval since surgery, %EBMI and current comorbidities logistic regression (c = 0.797) demonstrated shorter time since last surgeon visit was independently predictive of multivitamin use (p = 0.001). CONCLUSIONS: While it appears patients prefer to follow-up with their PCP, this study reveals a large disparity in malnutrition screening and nutrient supplementation following LRYGB. Therefore, implementation of multidisciplinary, best-practice guidelines to recognize and prevent malnutrition is paramount in the management of this growing population of high-risk patients. More... »

PAGES

1131-1136

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11695-016-2364-0

DOI

http://dx.doi.org/10.1007/s11695-016-2364-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1054525267

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28247320


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