Background

Morbid obesity is associated with serious health and social consequences. Socioeconomically disadvantaged people are less likely to undergo bariatric surgery than their socioeconomically advantaged counterparts. The Economic Innovation Group's Distressed Communities Index (DCI) offers a metric to assess socioeconomic distress. ObjectiveThis study investigated the relationship between community distress, as determined by DCI, and complications following bariatric surgery, including length of hospital stay, likelihood of an emergency department (ED) visit, 30-day readmissions, and peri-operative/post-operative occurrences.

Methods

We conducted a retrospective analysis on a cohort of patients undergoing initial sleeve gastrectomy or Roux-en-Y bypass at a large academic hospital from 2016-2020. Patients were categorized based on the DCI of their community. We used the MBSAQIP database to record each patient's post-operative complications. Descriptive statistics were used to evaluate the association between community distress and complications.

Results

Patients from distressed communities were more likely to have Medicaid and less likely to have private insurance (p < 0.001). Community distress was significantly correlated with longer hospital stay (p < 0.001) and a higher likelihood of an ED visit (p < 0.007). No significant correlation was observed between community distress and 30-day readmissions or peri-operative/post-operative occurrences.

Conclusions

Higher community distress levels are associated with extended hospital stays and increased ED visits among bariatric surgery patients. DCI score does not significantly impact likelihood of intra/post-op occurrences or 30-day readmissions. DCI is not an independent risk factor for complications after adjusting for other variables and is not a significant driver of short-term post operative occurrences.