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TOPLINE:

Almost 60% of patients with obesity and preexisting anemia recovered from anemia within 6 months after bariatric surgery. Female sex, older age, and sleeve gastrectomy (SG) as the surgery type were associated with increased odds of recovery.

METHODOLOGY:

• Studies have explored the development of anemia after metabolic bariatric surgery, but little is known about the effect of bariatric surgery on recovery from preexisting anemia.
• A retrospective cohort study analyzed data of 1664 adult patients (mean age, 44.66 years; mean preoperative body mass index [BMI], 49.24) with obesity and preexisting anemia who underwent primary metabolic bariatric surgery in Ontario, Canada, to identify the prevalence and predictors of anemia recovery in this patient population.
• Anemia was defined as hemoglobin levels below the World Health Organization (WHO) criteria of 130 g/L for men and 120 g/L for women. Patients with BMIs below the Ontario Bariatric Network’s surgery eligibility threshold of 35, those without 6-month follow-up data, and those who underwent revisional surgery were excluded.
• The bariatric procedures performed were Roux-en-Y gastric bypass or SG, with majority of the procedures conducted laparoscopically.
• The primary outcome was anemia recovery at 6 months postsurgery, with recovery defined as meeting WHO standards for normal hemoglobin levels. Secondary outcomes were recovery during 1-5 years after surgery.

TAKEAWAY:

• At 6 months after surgery, 57.2% of patients had recovered from preexisting anemia. Among patients with available longer-term data, 59.8% of patients had recovered from preexisting anemia at 1 year postsurgery and 69.7% at 5 years.
• Patients who underwent SG had higher odds of recovering from anemia than those who underwent Roux-en-Y gastric bypass (adjusted odds ratio [aOR], 1.41; P < .05).
• The odds of recovering from anemia were higher in women than in men (aOR, 1.93; P < .001) and in patients aged 45-54 years than in those younger than 35 years (aOR, 1.48; P < .05).
• Patients with preoperative hemoglobin levels of 11-20 g/L below WHO-defined thresholds had lower recovery odds than those with levels of 0-10 g/L below thresholds (aOR, 0.52; P < .001). Neither the BMI at the time of surgery nor the percentage of body weight loss after 6 months had a significant effect on anemia recovery.

IN PRACTICE:

“This study highlights that patients with obesity and preexisting anemia undergoing metabolic bariatric surgery experience a net benefit in recovery from anemia. It also highlights the preoperative patient characteristics associated with the highest odds of recovery and suggests that SG may be a better choice for metabolic bariatric surgery candidates with preexisting anemia,” the authors wrote.

SOURCE:

The study, led by Muhammad Faran, Centre for Surgical Invention and Innovation, Hamilton, Ontario, Canada, was published online in Obesity Surgery.

LIMITATIONS:

The database lacked information on iron supplementation. Unmeasured variables, such as dietary habits, may influence results as certain diets are linked to anemia risk. The absence of consistent reporting of ferritin levels limited the ability to use these levels in determining potential iron deficiency.

DISCLOSURES:

No external or internal funding was reported for this study. The authors disclosed having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.