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Influence of Ethnicity on the Efficacy and Utilization of Bariatric Surgery in the USA

Abstract

Background

Ethnic disparities in patterns of utilization and outcomes after Roux-en-Y gastric bypass surgery (RYGB) were examined from Bariatric Outcomes Longitudinal Database.

Methods

Descriptive statistics were used for demographics of Whites, Blacks, or Hispanics undergoing RYGB with 1 year of follow-up, between June 2007 and October 2011. Multivariate logistic and normal regression models, controlling for baseline characteristics, examined relationships between race and outcomes. T tests were used for continuous variables and Pearson chi-square test for categorical variables.

Results

Study patients (108,333) were79 % White, 12 % Black, and 9 % Hispanic. Fewer Black males underwent surgery (15 %) compared to Whites or Hispanics (∼22 %). Blacks compared to Whites were younger (42.7 ± 10.6 vs. 46.4 ± 11.6 years), heavier BMI (50 ± 9.1 vs. 47.4 ± 8.0 kg/m2), and more often hypertensive (57 vs. 52 %). Other comorbidities were higher in Whites. Thirty-day mortality rate was equivalent (0.23–0.26 %), but serious adverse events were higher for Blacks (3.65 %) versus Whites (3.19 %) and Hispanics (2.01 %). At 1 year, weight and comorbidity burden declined significantly but less in Blacks despite adjustment for baseline characteristics.

Conclusions

Fewer Black males underwent RYGB. Despite a smaller percent decline in BMI and comorbidities in Blacks, all races benefitted significantly from RYGB. Influence of other factors such as diet, culture, and genetics needs to be investigated further.

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Correspondence to Ranjan Sudan.

Additional information

Presented as an oral presentation at the Society for Surgery of the Alimentary Tract Annual Meeting, Orlando 2013 and was selected as Best of DDW presentation.

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Sudan, R., Winegar, D., Thomas, S. et al. Influence of Ethnicity on the Efficacy and Utilization of Bariatric Surgery in the USA. J Gastrointest Surg 18, 130–136 (2014). https://doi.org/10.1007/s11605-013-2368-1

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  • DOI: https://doi.org/10.1007/s11605-013-2368-1

Keywords

  • Bariatric surgery
  • Gastric bypass
  • Disparities
  • Ethnicity