Hypoalbuminemia as a risk factor for complications in revisional/conversional bariatric surgery: an MBSAQIP analysis

Perez, Samuel; Alessi, Isabella G.; Wheeler, Andrew A.

doi:10.1016/j.soard.2022.12.010

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…A younger age, lower BMI, and lower HbA1c are predictive of higher weight loss after bariatric surgery [111]. Multiple studies have identified hypoalbuminemia as a predictive factor of serious post-surgical complications [112][113][114]. Lower plasma phospholipid concentration and higher values of total branched-chain amino acids might act as helpful markers for impaired metabolism and metabolic disorders [115].…”

Section: Osteotomymentioning

confidence: 99%

Surgical Interventions for the Management of Obesity-Related Joint Pain: A Narrative Review

Alrayes,

Altawili,

Alsuabie

et al. 2024

Cureus

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Obesity-related joint pain is a common and debilitating condition that significantly impacts the quality of life, primarily due to the excess weight straining the joints. This results in inflammation and degeneration, which can cause pain, stiffness, and difficulty moving. We aimed to comprehensively review the literature discussing surgical interventions for obesity-related joint pain. We searched across databases (PubMed, Scopus, and Cochrane Library) to identify studies published between 2000 and 2023 that assessed surgical interventions for obesity-related joint pain. This review highlights the complex interplay of mechanical, inflammatory, and metabolic factors contributing to joint pain in obese individuals, highlighting both surgical and non-surgical interventions. Non-surgical interventions include weight loss, exercise, physical therapy, and medications. Surgical interventions include bariatric surgery and joint replacement surgery. Bariatric surgery significantly reduces body weight and improves the quality of life outcomes; however, multiple studies have found no improvement or worsening of joint pain post-surgery. Total joint arthroplasty has demonstrated good improvement in pain and function outcomes based on recent meta-analyses, although risks of complications are higher in obese patients. The treatment choice for obesity-related joint pain depends on the individual patient’s circumstances. Non-surgical interventions are usually the first line of treatment. However, if these interventions are not effective, surgical interventions may be an option.

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Section: Osteotomymentioning

confidence: 99%

Surgical Interventions for the Management of Obesity-Related Joint Pain: A Narrative Review

Alrayes,

Altawili,

Alsuabie

et al. 2024

Cureus

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“…Thus, several surgeons tend to measure the TSBL and tailor the bypassed length accordingly [ 8 ]. Due to the variability in TSBL, some studies recommend at least 3 to 4 m of common channel limb length (CCLL) to be measured, rather than tailoring of BPLL, in order to prevent nutritional complications [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Prevention of malnutrition after one anastomosis gastric bypass: value of the common channel limb length

Mostafapour,

Shahsavan,

Shahmiri

et al. 2024

BMC Surg

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Purpose Hypoalbuminemia and anemia are commonly observed indications for one anastomosis gastric bypass (OAGB) reversal and remain significant concerns following the procedure. Sufficient common channel limb length (CCLL) is crucial to minimize nutritional complications. However, limited literature exists regarding the impact of CCLL on OAGB outcomes. This study aimed to assess the effect of CCLL on weight loss and nutritional status in patients who underwent OAGB. Methods A prospective cohort study was conducted from August 2021 to July 2022, involving 64 patients with a body mass index of 40–50 kg/m2. The standardized length of the biliopancreatic limb (BPLL) for all patients in this study was set at 175 cm. Additionally, the measurement of the common channel limb length (CCLL) was performed consistently by the same surgeon for all included patients. Results The mean age and BMI of the patients were 39.91 ± 10.03 years and 43.13 ± 2.43 kg/m2, respectively, at the time of surgery. There was a statistically significant negative correlation between CCLL and percent total weight loss (%TWL) at the 12-month mark after OAGB (P = 0.02). Hypoalbuminemia was observed in one patient (1.6%), while anemia was present in 17 patients (26.6%) at the one-year follow-up. Statistical analysis revealed no significant difference in the incidence of anemia and hypoalbuminemia between patients with CCLL < 4 m and those with CCLL ≥ 4 m. Conclusion A CCLL of 4 m does not appear to completely prevent nutritional complications following OAGB. However, maintaining a CCLL of at least 4 m may be associated with a reduced risk of postoperative nutritional deficiencies.

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“…The risks for surgery in hypoalbuminemic patients are substantial extending even to those undergoing metabolic surgery for obesity. 21 The initial purpose of our proposal to define the pathophysiology of protein energy malnutrition as that being starvation-induced, acute inflammation-related, or chronic inflammation-related was based on this concept that starvation and inflammation and their interaction were key to their genesis. 22 We used the term protein energy undernutrition in that article to represent the condition of hypoalbuminemic malnutrition employed here, but I believe hypoalbuminemic malnutrition may be more revealing and explanatory as to etiology given the clear relationship between hypoalbuminemia and outcomes, which were unrivaled in nutrition terms.…”

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confidence: 99%

“…In the early landmark Veterans’ Affairs trial of preoperative feeding of surgical patients before abdominal surgery it was found that only in the severely malnourished patients diagnosed by weight loss and serum albumin levels did benefit in terms of noninfectious outcomes occur 20 from what would now be considered excessive parenteral nutrition therapy. The risks for surgery in hypoalbuminemic patients are substantial extending even to those undergoing metabolic surgery for obesity 21 …”

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confidence: 99%

Hypoalbuminemic malnutrition

Bistrian

2023

J Parenter Enteral Nutr

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Fifty years ago, we originally used anthropometric measures of weight/height and upper arm anthropometry and serum albumin levels to define and document the high prevalence of protein energy malnutrition in adult surgical patients in a municipal hospital in Boston 1 based on my experience with similar practices in pediatric patients in Haiti during an elective rotation in a philanthropic hospital during my medical training. This was soon followed by a similar survey repeated at several weekly intervals in adult medical patients also demonstrating high prevalence of protein energy malnutrition and little change over time, but with less hypoalbuminemia and lower weight/height in the medical patients. 2 In both surgical and medical surveys, arm muscle circumference was significantly associated with serum albumin levels. 1,2 This seemed to conform with two types of pediatric protein energy malnutrition I had first seen in Haiti, marasmus, defined

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Hypoalbuminemia as a risk factor for complications in revisional/conversional bariatric surgery: an MBSAQIP analysis

Cited by 6 publications

References 26 publications

Surgical Interventions for the Management of Obesity-Related Joint Pain: A Narrative Review

Surgical Interventions for the Management of Obesity-Related Joint Pain: A Narrative Review

Prevention of malnutrition after one anastomosis gastric bypass: value of the common channel limb length

Hypoalbuminemic malnutrition

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