Racial disparities in perioperative outcomes after bariatric surgery.


Journal

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161

Informations de publication

Date de publication:
May 2019
Historique:
received: 18 08 2018
accepted: 14 12 2018
pubmed: 18 2 2019
medline: 25 4 2020
entrez: 18 2 2019
Statut: ppublish

Résumé

NonHispanic black patients bear a disproportionate burden of the obesity epidemic and its related medical co-morbidities. While bariatric surgery is the most effective treatment for morbid obesity, black patients access bariatric surgery at lower rates than nonHispanic white patients. To examine racial differences before bariatric surgery and in short-term perioperative outcomes and complications, and the extent to which race is independently associated with perioperative morbidity and mortality. Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program national database. Data were extracted from the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant Use File. Multivariate analysis was used to identify differences in mortality, length of stay, readmission, and reintervention by race in patients undergoing laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy (SG). A total of 108,198 patients were included in the analysis. There were significant differences in perioperative disease burden. Black patients had a higher body mass index at the time they underwent surgery (laparoscopic Roux-en-Y gastric bypass: 48.0 versus 45.7 kg/m We found significant racial disparities in bariatric surgery outcomes, including higher mortality in black patients undergoing SG. The specific causes of these disparities remain unclear and must be the subject of future research.

Sections du résumé

BACKGROUND BACKGROUND
NonHispanic black patients bear a disproportionate burden of the obesity epidemic and its related medical co-morbidities. While bariatric surgery is the most effective treatment for morbid obesity, black patients access bariatric surgery at lower rates than nonHispanic white patients.
OBJECTIVES OBJECTIVE
To examine racial differences before bariatric surgery and in short-term perioperative outcomes and complications, and the extent to which race is independently associated with perioperative morbidity and mortality.
SETTING METHODS
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program national database.
METHODS METHODS
Data were extracted from the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant Use File. Multivariate analysis was used to identify differences in mortality, length of stay, readmission, and reintervention by race in patients undergoing laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy (SG).
RESULTS RESULTS
A total of 108,198 patients were included in the analysis. There were significant differences in perioperative disease burden. Black patients had a higher body mass index at the time they underwent surgery (laparoscopic Roux-en-Y gastric bypass: 48.0 versus 45.7 kg/m
CONCLUSIONS CONCLUSIONS
We found significant racial disparities in bariatric surgery outcomes, including higher mortality in black patients undergoing SG. The specific causes of these disparities remain unclear and must be the subject of future research.

Identifiants

pubmed: 30772252
pii: S1550-7289(18)30512-4
doi: 10.1016/j.soard.2018.12.021
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

786-793

Subventions

Organisme : NIDDK NIH HHS
ID : T32 DK108733
Pays : United States

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Adam C Sheka (AC)

Department of Surgery, University of Minnesota, Minneapolis, Minnesota.

Scott Kizy (S)

Department of Surgery, University of Minnesota, Minneapolis, Minnesota.

Keith Wirth (K)

Department of Surgery, University of Minnesota, Minneapolis, Minnesota.

Jayleen Grams (J)

Department of Surgery, University of Alabama, Birmingham, Alabama.

Daniel Leslie (D)

Department of Surgery, University of Minnesota, Minneapolis, Minnesota.

Sayeed Ikramuddin (S)

Department of Surgery, University of Minnesota, Minneapolis, Minnesota. Electronic address: ikram001@umn.edu.

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Classifications MeSH