Racial Disparities in Bariatric Surgery Complications and Mortality Using the MBSAQIP Data Registry
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Racial Disparities in Bariatric Surgery Complications and Mortality Using the MBSAQIP Data Registry Leonard K. Welsh 1 & Andrew R. Luhrs 1 & Gerardo Davalos 1 & Ramon Diaz 1 & Andres Narvaez 1 & Juan Esteban Perez 1 & Reginald Lerebours 2 & Maragatha Kuchibhatla 2 & Dana D. Portenier 1 & Alfredo D. Guerron 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Racial disparities in postoperative complications have been demonstrated in bariatric surgery, yet the relationship of race to complication severity is unknown. Study Design Adult laparoscopic primary bariatric procedures were queried from the 2015 and 2016 MBSAQIP registry. Adjusted logistic and multinomial regressions were used to examine the relationships between race and 30-day complications categorized by the Clavien-Dindo grading system. Results A total of 212,970 patients were included in the regression analyses. For Black patients, readmissions were higher (OR = 1.39, p < 0.0001) and the odds of a Grade 1, 3, 4, or 5 complication were increased compared with White patients (OR = 1.21, p < 0.0001; OR = 1.21, p < 0.0001; OR = 1.22, p = 0.01; and OR = 1.43, p = 0.04) respectively. The odds of a Grade 3 complication for Hispanic patients were higher compared with White patients (OR = 1.59, p < 0.0001). Conclusion Black patients have higher odds of readmission and multiple grades of complications (including death) compared with White patients. Hispanic patients have higher odds of a Grade 3 complication compared with White patients. No significant differences were found with other races. Specific causes of these disparities are beyond the limitations of the dataset and stand as a topic for future inquiry. Keywords MBSAQIP . Racial disparities . Outcomes . Clavien-Dindo
Introduction Obesity is the most prevalent chronic disease and a leading cause of morbidity and mortality in the USA. More than one-third of the US adult population meets the criteria for a diagnosis of obesity [1]. Obesity does not affect all racial and ethnic groups equally. According to the National Center for Health Statistics, non-Hispanic African American women are the most at-risk group, followed by Hispanic, non-Hispanic whites, and Asian women [1]. Similar trends are found among men. Weight loss surgery
* Alfredo D. Guerron [email protected] 1
Division of Metabolic and Weight Loss Surgery, Department of Surgery, Duke University, 407 Crutchfield St., Durham, NC 27704, USA
2
Department of Biostatistics and Bioinformatics, Duke University, 2424 Erwin Rd, Durham 27710, USA
remains the most effective treatment for moderate to severe obesity and resolution of obesity-related comorbidities [2–7]. Most bariatric operations have very low rates of morbidity and mortality [8] and are among the more commonly performed operations in the USA [9]. Racial disparities in operative outcomes have been demonstrated in many major surgical operations [10–12] and parallel findings have been demonstrated in bariatric surgery [1
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