Evidence mapPaperPMID 28470489Full record

ArticleObesity surgery2017

Hypocalcemia After Bariatric Surgery: Prevalence and Associated Risk Factors.

Meera Shah, Anu Sharma, Robert A Wermers, Kurt A Kennel, Todd A Kellogg, Manpreet S Mundi

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Article in Obesity surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

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19citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Meera ShahDivision of Endocrinology, Metabolism and Nutrition, Mayo Clinic, 200 1st Street SW Rochester, Rochester, MN, 55905, USA. shah.meera@mayo.edu.ORCID 0000-0001-8898-2456
Anu SharmaDivision of Endocrinology, Metabolism and Nutrition, Mayo Clinic, 200 1st Street SW Rochester, Rochester, MN, 55905, USA.
Robert A WermersDivision of Endocrinology, Metabolism and Nutrition, Mayo Clinic, 200 1st Street SW Rochester, Rochester, MN, 55905, USA.
Kurt A KennelDivision of Endocrinology, Metabolism and Nutrition, Mayo Clinic, 200 1st Street SW Rochester, Rochester, MN, 55905, USA.
Todd A KelloggDivision of Breast, Metabolic and Gastrointestinal Surgery, Mayo Clinic, 200 1st Street SW Rochester, Rochester, MN, 55905, USA.
Manpreet S MundiDivision of Endocrinology, Metabolism and Nutrition, Mayo Clinic, 200 1st Street SW Rochester, Rochester, MN, 55905, USA.

Funding

NCATS NIH HHS UL1 TR000135
6 · The paper itself

Abstract

backgroundThe reported prevalence of hypocalcemia after bariatric surgery ranges from 1% after Roux-en-Y gastric bypass (RYGB) to 25% after bilio-pancreatic diversion-duodenal switch (BPD-DS).

objectiveWe aimed to define the prevalence of post-operative hypocalcemia and identify clinical predisposing factors.

settingThe study was conducted in an Academic Medical Center, USA.

methodsRetrospective analysis of all patients undergoing bariatric surgery from May 2008 to December 2014 at Mayo Clinic Rochester, Minnesota was performed. Patients with revision surgeries were excluded. Hypocalcemia was defined as the lowest recorded serum calcium occurring at least 2 weeks post-operatively.

resultsNine hundred ninety-nine patients fulfilled the criteria above. After correction for serum albumin concentration, 36 patients had serum calcium ≤8.9 mg/dl. Mean serum calcium was 8.1 ± 0.6 mg/dl. The prevalence was 1.9% in the RYGB group, 9.3% in the sleeve gastrectomy (SG) group, and 10% in the BPD-DS group. In all three surgical types, patients with hypocalcemia had significantly lower serum albumin and serum 25 (OH) vitamin D concentrations when compared to their normocalcemic counterparts (P < 0.01). The presence of renal insufficiency and vitamin D deficiency was associated with the highest risk of developing hypocalcemia after surgery [OR 16.8 (6.45-47.7) and 7.1(2.9-17.3), respectively]. Pre-operative renal insufficiency increased the odds of developing hypocalcemia by 20-fold.

conclusionsIn our series, hypocalcemia was identified in 3.6% of patients undergoing all bariatric surgery. Patients who are predisposed to developing post-operative hypocalcemia, such as those with pre-operative renal impairment, or post-operative vitamin D deficiency and renal insufficiency, may benefit from increased surveillance and prevention strategies.

Indexed as

AdultBariatric SurgeryFemaleHumansHypocalcemiaMaleMiddle AgedMinnesotaObesity, MorbidPostoperative PeriodPrevalenceReoperationRetrospective StudiesRisk FactorsVitamin DVitamin DBilio-pancreatic diversionDuodenal switchHypocalcemiaRenal impairmentRoux-en-Y gastric bypassSleeve gastrectomyVitamin D deficiency

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.