The Role of Preoperative Anemia in Predicting Short-Term Morbidity and Mortality After Roux-en-Y Gastric Bypass
Background Preoperative anemia has been suggested as a contraindication to gastric bypass. Using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement database, this study sought to determine the role of preoperative hematocrit on 30-day morbidity and mortality after laparoscopic...
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| Veröffentlicht in: | The American surgeon 2020-12, Vol.87 (12), p.1926-1933 |
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| container_issue | 12 |
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| container_title | The American surgeon |
| container_volume | 87 |
| creator | Wise, Eric S. Beckman, Tiffany R. Amateau, Stuart K. Ikramuddin, Sayeed Leslie, Daniel B. |
| description | Background
Preoperative anemia has been suggested as a contraindication to gastric bypass. Using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement database, this study sought to determine the role of preoperative hematocrit on 30-day morbidity and mortality after laparoscopic Roux-en-Y gastric bypass for weight loss.
Methods
A cohort of 31 981 patients was reviewed for factors associated with a composite primary end point including 30-day reoperation, readmission, reintervention, or mortality, including degree of anemia. Analyzed separately by gender, factors significant on bivariate analysis were included in nominal logistic multivariate analysis to assess for independent significance of the hematocrit level as a risk factor for the primary end point.
Results
Upon multivariate analysis, the hematocrit level was significantly associated with the 30-day end point in the male cohort (P = .05), specifically, severe anemia (hematocrit |
| doi_str_mv | 10.1177/0003134820982852 |
| format | Article |
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Preoperative anemia has been suggested as a contraindication to gastric bypass. Using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement database, this study sought to determine the role of preoperative hematocrit on 30-day morbidity and mortality after laparoscopic Roux-en-Y gastric bypass for weight loss.
Methods
A cohort of 31 981 patients was reviewed for factors associated with a composite primary end point including 30-day reoperation, readmission, reintervention, or mortality, including degree of anemia. Analyzed separately by gender, factors significant on bivariate analysis were included in nominal logistic multivariate analysis to assess for independent significance of the hematocrit level as a risk factor for the primary end point.
Results
Upon multivariate analysis, the hematocrit level was significantly associated with the 30-day end point in the male cohort (P = .05), specifically, severe anemia (hematocrit <35%) conferred an increased risk relative to a normal hematocrit (odds ratio 1.5, P = .03). There was no association of hematocrit with the 30-day end point in the female cohort.
Conclusion
Bariatricians should carefully consider the appropriateness of a gastric bypass over a less anemogenic procedure such as sleeve gastrectomy in patients, particularly men with preoperative anemia.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/0003134820982852</identifier><identifier>PMID: 33502216</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Anemia ; Anemia - blood ; Anemia - complications ; Bivariate analysis ; Body mass index ; Chronic obstructive pulmonary disease ; Contraindications, Procedure ; Female ; Gastrectomy ; Gastric bypass ; Gastric Bypass - adverse effects ; Gastric Bypass - mortality ; Gastroesophageal reflux ; Gastrointestinal surgery ; Hematocrit ; Hospital Mortality ; Humans ; Laparoscopy ; Life Sciences & Biomedicine ; Male ; Men ; Middle Aged ; Morbidity ; Mortality ; Multivariate analysis ; Obesity, Morbid - surgery ; Patient Readmission ; Patients ; Preoperative Period ; Quality control ; Reoperation ; Risk analysis ; Risk factors ; Science & Technology ; Sleep apnea ; Surgery ; Weight loss ; Womens health</subject><ispartof>The American surgeon, 2020-12, Vol.87 (12), p.1926-1933</ispartof><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>1</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000729843800001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c365t-ca781352c4f9497aed107380aad42296830a2cd6aca53d08ca474548126e27e03</citedby><cites>FETCH-LOGICAL-c365t-ca781352c4f9497aed107380aad42296830a2cd6aca53d08ca474548126e27e03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0003134820982852$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0003134820982852$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,781,785,21824,27929,27930,28253,43626,43627</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33502216$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wise, Eric S.</creatorcontrib><creatorcontrib>Beckman, Tiffany R.</creatorcontrib><creatorcontrib>Amateau, Stuart K.</creatorcontrib><creatorcontrib>Ikramuddin, Sayeed</creatorcontrib><creatorcontrib>Leslie, Daniel B.</creatorcontrib><title>The Role of Preoperative Anemia in Predicting Short-Term Morbidity and Mortality After Roux-en-Y Gastric Bypass</title><title>The American surgeon</title><addtitle>AM SURGEON</addtitle><addtitle>Am Surg</addtitle><description>Background
Preoperative anemia has been suggested as a contraindication to gastric bypass. Using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement database, this study sought to determine the role of preoperative hematocrit on 30-day morbidity and mortality after laparoscopic Roux-en-Y gastric bypass for weight loss.
Methods
A cohort of 31 981 patients was reviewed for factors associated with a composite primary end point including 30-day reoperation, readmission, reintervention, or mortality, including degree of anemia. Analyzed separately by gender, factors significant on bivariate analysis were included in nominal logistic multivariate analysis to assess for independent significance of the hematocrit level as a risk factor for the primary end point.
Results
Upon multivariate analysis, the hematocrit level was significantly associated with the 30-day end point in the male cohort (P = .05), specifically, severe anemia (hematocrit <35%) conferred an increased risk relative to a normal hematocrit (odds ratio 1.5, P = .03). There was no association of hematocrit with the 30-day end point in the female cohort.
Conclusion
Bariatricians should carefully consider the appropriateness of a gastric bypass over a less anemogenic procedure such as sleeve gastrectomy in patients, particularly men with preoperative anemia.</description><subject>Adult</subject><subject>Anemia</subject><subject>Anemia - blood</subject><subject>Anemia - complications</subject><subject>Bivariate analysis</subject><subject>Body mass index</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Contraindications, Procedure</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastric bypass</subject><subject>Gastric Bypass - adverse effects</subject><subject>Gastric Bypass - mortality</subject><subject>Gastroesophageal reflux</subject><subject>Gastrointestinal surgery</subject><subject>Hematocrit</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Men</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Obesity, Morbid - surgery</subject><subject>Patient Readmission</subject><subject>Patients</subject><subject>Preoperative Period</subject><subject>Quality control</subject><subject>Reoperation</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Science & Technology</subject><subject>Sleep apnea</subject><subject>Surgery</subject><subject>Weight loss</subject><subject>Womens health</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkc2LFDEQxYMo7rh69yQBL4K05jvp4zjoKqwoOh48NZl09W6W7mQ2Savz35tm1hUWBHMJL_V7j6oUQk8peUWp1q8JIZxyYRhpDTOS3UMrKqVsquL30WopN0v9BD3K-apKoSR9iE44l4QxqlYobi8Bf4kj4DjgzwniHpIt_gfgdYDJW-zD8tx7V3y4wF8vYyrNFtKEP8a0870vB2xDv6hix0WthwKpRs6_GgjNd3xmc0ne4TeHvc35MXow2DHDk5v7FH1793a7ed-cfzr7sFmfN44rWRpntaFcMieGVrTaQk-J5oZY2wvGWmU4scz1yjoreU-Ms0ILKQxlCpgGwk_Ri2PuPsXrGXLpJp8djKMNEOfcscoqxbSWFX1-B72Kcwq1u44pJpggpF0CyZFyKeacYOj2yU82HTpKumUZ3d1lVMuzm-B5N0F_a_jz-xUwR-An7OKQnYfg4BareZq1RtSx66EbX-piYtjEOZRqffn_1ko3RzrbC_g73j87_w3I1q_i</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Wise, Eric S.</creator><creator>Beckman, Tiffany R.</creator><creator>Amateau, Stuart K.</creator><creator>Ikramuddin, Sayeed</creator><creator>Leslie, Daniel B.</creator><general>SAGE Publications</general><general>Sage</general><general>SAGE PUBLICATIONS, INC</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20201201</creationdate><title>The Role of Preoperative Anemia in Predicting Short-Term Morbidity and Mortality After Roux-en-Y Gastric Bypass</title><author>Wise, Eric S. ; Beckman, Tiffany R. ; Amateau, Stuart K. ; Ikramuddin, Sayeed ; Leslie, Daniel B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-ca781352c4f9497aed107380aad42296830a2cd6aca53d08ca474548126e27e03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Anemia</topic><topic>Anemia - blood</topic><topic>Anemia - complications</topic><topic>Bivariate analysis</topic><topic>Body mass index</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Contraindications, Procedure</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Gastric bypass</topic><topic>Gastric Bypass - adverse effects</topic><topic>Gastric Bypass - mortality</topic><topic>Gastroesophageal reflux</topic><topic>Gastrointestinal surgery</topic><topic>Hematocrit</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>Men</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Obesity, Morbid - surgery</topic><topic>Patient Readmission</topic><topic>Patients</topic><topic>Preoperative Period</topic><topic>Quality control</topic><topic>Reoperation</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Science & Technology</topic><topic>Sleep apnea</topic><topic>Surgery</topic><topic>Weight loss</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wise, Eric S.</creatorcontrib><creatorcontrib>Beckman, Tiffany R.</creatorcontrib><creatorcontrib>Amateau, Stuart K.</creatorcontrib><creatorcontrib>Ikramuddin, Sayeed</creatorcontrib><creatorcontrib>Leslie, Daniel B.</creatorcontrib><collection>Web of Science - 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Academic</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wise, Eric S.</au><au>Beckman, Tiffany R.</au><au>Amateau, Stuart K.</au><au>Ikramuddin, Sayeed</au><au>Leslie, Daniel B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Role of Preoperative Anemia in Predicting Short-Term Morbidity and Mortality After Roux-en-Y Gastric Bypass</atitle><jtitle>The American surgeon</jtitle><stitle>AM SURGEON</stitle><addtitle>Am Surg</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>87</volume><issue>12</issue><spage>1926</spage><epage>1933</epage><pages>1926-1933</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><abstract>Background
Preoperative anemia has been suggested as a contraindication to gastric bypass. Using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement database, this study sought to determine the role of preoperative hematocrit on 30-day morbidity and mortality after laparoscopic Roux-en-Y gastric bypass for weight loss.
Methods
A cohort of 31 981 patients was reviewed for factors associated with a composite primary end point including 30-day reoperation, readmission, reintervention, or mortality, including degree of anemia. Analyzed separately by gender, factors significant on bivariate analysis were included in nominal logistic multivariate analysis to assess for independent significance of the hematocrit level as a risk factor for the primary end point.
Results
Upon multivariate analysis, the hematocrit level was significantly associated with the 30-day end point in the male cohort (P = .05), specifically, severe anemia (hematocrit <35%) conferred an increased risk relative to a normal hematocrit (odds ratio 1.5, P = .03). There was no association of hematocrit with the 30-day end point in the female cohort.
Conclusion
Bariatricians should carefully consider the appropriateness of a gastric bypass over a less anemogenic procedure such as sleeve gastrectomy in patients, particularly men with preoperative anemia.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>33502216</pmid><doi>10.1177/0003134820982852</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Anemia Anemia - blood Anemia - complications Bivariate analysis Body mass index Chronic obstructive pulmonary disease Contraindications, Procedure Female Gastrectomy Gastric bypass Gastric Bypass - adverse effects Gastric Bypass - mortality Gastroesophageal reflux Gastrointestinal surgery Hematocrit Hospital Mortality Humans Laparoscopy Life Sciences & Biomedicine Male Men Middle Aged Morbidity Mortality Multivariate analysis Obesity, Morbid - surgery Patient Readmission Patients Preoperative Period Quality control Reoperation Risk analysis Risk factors Science & Technology Sleep apnea Surgery Weight loss Womens health |
| title | The Role of Preoperative Anemia in Predicting Short-Term Morbidity and Mortality After Roux-en-Y Gastric Bypass |
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