Prevalence of Anemia and Use of Red Cell Distribution Width as a Predictive Tool in a Bariatric Surgery Population

Abstract

<bold>Background</bold> Anemia is among the most common conditions resulting from nutrient deficiency in bariatric surgery populations. The symptoms of anemia can have a negative impact on favorable outcomes. The primary aim of this study was to establish prevalence rates and characterization of subjects with new onset anemia after bariatric surgery. The secondary aim was to determine if red cell distribution width (RDW) could serve as a predictive tool for anemia outcomes. <bold>Methods</bold> A cohort study which included patients who had undergone Roux-en-Y gastric bypass, adjustable gastric banding, or vertical sleeve gastrectomy was conducted. Hematological parameters from the Complete Blood Count (CBC) were collected and analyzed. <bold>Results</bold> At baseline, 217 subjects were included, of which 16% had anemia prior to surgery. Longitudinal data of 93 subjects revealed 16% post-surgical incidence and 32% prevalence of anemia at 6 months. Subjects who became anemic versus those who did not were distributed in significantly different manner by gender and race, and the anemic group tended toward microcytosis. New and unresolved cases of anemia after surgery were mostly seen among RYGB patients. Finally, RDW values at 6 months were not found to be predictive of changes in hemoglobin at 12 months. <bold>Conclusion</bold> Approximately one in six bariatric surgery candidates is anemic prior to surgery, and almost one third will experience anemia within the first year after surgery. A multivitamin with iron may not be enough to prevent nutrient-related anemia after bariatric surgery for some patients.