Long-term micronutrient surveillance after gastric bypass surgery in an integrated healthcare system

Surg Obes Relat Dis. 2019 Mar;15(3):389-395. doi: 10.1016/j.soard.2018.12.029. Epub 2019 Jan 9.

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.

Keywords: Laboratory testing; Long-term follow-up; Obesity; Primary care; Roux-en-Y gastric bypass.

MeSH terms

  • Adult
  • Delivery of Health Care, Integrated*
  • Female
  • Gastric Bypass*
  • Guideline Adherence*
  • Humans
  • Laparoscopy
  • Male
  • Micronutrients / blood*
  • Middle Aged
  • Obesity, Morbid / blood*
  • Obesity, Morbid / surgery*
  • Practice Guidelines as Topic
  • Weight Loss

Substances

  • Micronutrients