Effect of Race and Ethnicity On Outcomes After Bariatric Surgery

Prateek K Gupta, MD, Himani Gupta, MD, R. Armour Forse, MD PhD. Creighton University

Objective: Racial and ethnic disparities for surgical outcomes exist, but investigations of such disparities after bariatric surgery have been limited to comparison of Blacks and Whites. No prior study has comprehensively analyzed the effect of race and ethnicity, including American Indians, Asians, Pacific Islanders, and Hispanics, on perioperative morbidity and mortality after bariatric surgery.

Methods: Patients undergoing bariatric surgery were identified from the ACS’ NSQIP (2006, 2007, and 2008). Thirty-day outcomes were studied using univariate and multivariate logistic regression analyses.

Results: Of 32,889 patients who underwent bariatric surgery, 79.6% were females, with median age being 45 years. Whites comprised 74.0% of the patients; Blacks comprised 12.3%; Hispanics comprised 5.5%; Asians/Pacific Islanders comprised 0.3%; and American Indians comprised 0.3%. On univariate analysis, similar rates of cardiac, renal, respiratory, thromboembolic, and infectious complications were seen among the racial and ethnic groups. Thirty-day mortality rate was the highest for Asians/Pacific Islanders (0.55%) and lowest for Hispanics (0.05%) (p=0.01). On multivariate logistic regression analyses for postoperative morbidity and mortality, after controlling for more than 50 comorbidities and type of surgery, a statistically significant difference was not seen among the racial and ethnic groups.

Conclusion: Race is not an independent predictor of postoperative mortality or morbidity after bariatric surgery.