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Menser T, Muniz Castro J, Lopez A, et al. Post-bariatric surgery lab tests: are they excessive and redundant?. Surg Endosc. 2019;34(10):4626-4631doi: 10.1007/s00464-019-07216-9.
Menser, T., Muniz Castro, J., Lopez, A., Jones, S. L., Kash, B. A., Sherman, V., & Tariq, N. (2020). Post-bariatric surgery lab tests: are they excessive and redundant?. Surgical endoscopy, 34(10), 4626-4631. https://doi.org/10.1007/s00464-019-07216-9
Menser, Terri, et al. "Post-bariatric surgery lab tests: are they excessive and redundant?." Surgical endoscopy vol. 34,10 (2020): 4626-4631. doi: https://doi.org/10.1007/s00464-019-07216-9
Menser T, Muniz Castro J, Lopez A, Jones SL, Kash BA, Sherman V, Tariq N. Post-bariatric surgery lab tests: are they excessive and redundant?. Surg Endosc. 2020 Oct;34(10):4626-4631. doi: 10.1007/s00464-019-07216-9. Epub 2019 Nov 01. PMID: 31676922; PMCID: PMC7525273.
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Surg Endosc. 2020 Oct;34(10):4626-4631. doi: 10.1007/s00464-019-07216-9. Epub 2019 Nov 01.

Post-bariatric surgery lab tests: are they excessive and redundant?.

Surgical endoscopy

Terri Menser, Jose Muniz Castro, Adriana Lopez, Stephen L Jones, Bita A Kash, Vadim Sherman, Nabil Tariq

Affiliations

  1. Department of Surgery, Houston Methodist, 6550 Fannin Street, Smith Tower, Suite 1601, Houston, TX, 77030, USA.
  2. Center for Outcomes Research and Department of Surgery, Houston Methodist, Houston, TX, USA.
  3. Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
  4. Department of Surgery, Weill Cornell Medical College, New York, NY, USA.
  5. Department of Surgery, Houston Methodist, 6550 Fannin Street, Smith Tower, Suite 1601, Houston, TX, 77030, USA. [email protected].
  6. Department of Surgery, Weill Cornell Medical College, New York, NY, USA. [email protected].

PMID: 31676922 PMCID: PMC7525273 DOI: 10.1007/s00464-019-07216-9

Abstract

INTRODUCTION: Following bariatric surgery, ongoing postoperative testing is required to measure nutritional deficiencies; the purpose of this study was to quantify the prevalence of these nutritional deficiencies based on two-year follow-up tests at recommended time points.

METHODS AND PROCEDURES: A retrospective data analysis was conducted of all laboratory tests for bariatric patients who underwent surgery between May 2016 and January 2018 with available lab data (n = 397). Results for nine different nutritional labs were categorized into six recommended postoperative time periods based on time elapsed since the procedure date. Binary variables were created for each laboratory result to calculate descriptive statistics of abnormalities for each lab test over time and used in the individual GEE logistic regression models. Grouped logistic regression examined the total nutritional deficiencies of the nine combined nutrients considering total available labs.

RESULTS: Multiple lab tests indicated a very low frequency of abnormalities (e.g., Vitamin A, Vitamin B12, Copper, and Folate). Many of the nine included nutritional labs had an average deficiency of less than 10% across all time points. The grouped logistic model found preoperative nutritional deficiency to be predictive of postoperative nutritional deficiency (OR 3.70, p < 0.001).

CONCLUSIONS: We found the vast majority of routine lab test results to be normal at multiple time points. Current practice can add up to significant lab expenses over time. The frequency of postoperative testing in this population may be redundant and of very little value. Unnecessary follow-up laboratory testing costs the patients and the health care system in both time and resources. Patients with preoperative deficiencies appear to be at higher risk for nutritional deficiencies when compared to bariatric surgery patients that did not have preoperative nutritional deficiencies. Future research should focus on defining cost effective postoperative lab testing guidelines for at risk bariatric patients.

Keywords: Bariatric surgery; Clinical laboratory tests; Nutrition assessment; Outcomes research; Postoperative period; Unnecessary procedures

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