Management of iron deficiency and anemia after Roux-en-Y gastric bypass surgery: an observational study.
Study Goal
The researchers aimed to evaluate the management of iron deficiency and anemia in patients who underwent Roux-en-Y gastric bypass surgery (RYGB).
Results Summary
The study found that iron management was inadequate, with many patients remaining deficient for prolonged periods. Intravenous iron administration (400-1400 mg) improved hemoglobin and ferritin levels significantly.
Population
RYGB patients (89% female, 86% Caucasian) with iron deficiency or anemia.
Effective Dosage
400-1400 mg intravenous iron (protocol-based).
Duration
Mean follow-up of 45.7 months.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
oral iron | neutral | - | RYGB patients with ID or anemia | - | had been prescribed | #1 |
intravenous iron | neutral | - | RYGB patients with ID or anemia | - | had been prescribed | #2 |
multiple blood transfusions | neutral | - | RYGB patients with ID or anemia | - | received | #3 |
intravenous iron using the new protocol (400-1400 mg) | increase | Hb | RYGB patients with ID or anemia | 1.8 g/dL | resulting in increases in | #4 |
intravenous iron using the new protocol (400-1400 mg) | increase | ferritin | RYGB patients with ID or anemia | 31.8 ng/mL | resulting in increases in | #5 |
administration of intravenous iron | neutral | - | RYGB patients with ID or anemia | - | was beneficial | #6 |
BACKGROUND: Iron deficiency (ID) is common after Roux-en-Y gastric bypass surgery (RYGB). Optimal iron management in this population is unclear. The objective of this study was to assess our management of RYGB patients with ID and anemia. METHODS: Clinic visit records of RYGB patients with ID or anemia from January 1, 2008, to February 1, 2010 were evaluated. Demographic characteristics, postsurgery iron and anemia indices, and prescribed treatments were recorded. Three separate definitions for ID and anemia were used (standard textbook, ASBMS, and recent literature). An intravenous iron protocol was later implemented, and follow-up laboratory values were obtained. RESULTS: A total of 125 with ID or anemia (89% female, 86% Caucasian), mean (SD) age 44.7 (8.6) years, and BMI 47.3 (10.8) kg/m(2) at time of RYGB, were included. Proportion of values meeting criteria for ID or anemia at first follow-up: standard textbook, hemoglobin (Hb, 35%), transferrin saturation (Tsat, 48%), ferritin (28%); ASBMS, ferritin (43%); recent literature, ferritin (58%), serum iron (21%). At mean follow-up of 45.7 (43) months, oral iron (n = 49) or intravenous iron (n = 4) had been prescribed for 53 (42.4%) patients, and 32 (25.6%) patients received multiple blood transfusions. Nine patients received intravenous iron using the new protocol (400-1400 mg), resulting in increases in Hb (1.8 g/dL; P<.05) and ferritin (31.8 ng/mL; P< .002). CONCLUSION: Iron management was inadequate. Hematologic values often were deficient for sustained periods. Initially, few patients received intravenous iron after oral iron failure, many received no iron supplementation, and there was high use of blood transfusions. Subsequently, administration of intravenous iron was beneficial.