Background

There is a paucity of data regarding racial disparities in bariatric surgery outcomes. This study aims to assess racial and ethnic disparities in bariatric care and represents the largest analysis of the MBSAQIP database to date.ObjectivesTo analyze preoperative variables, intraoperative factors, and 30-day postoperative outcomes, comparing white vs. Black race and Hispanic vs. non-Hispanic ethnic groups.

Methods

A retrospective analysis included 1,193,655 patients undergoing Roux-en-Y gastric bypass, sleeve gastrectomy, and duodenal switch from the MBSAQIP database (2015-2021). Endoscopic, emergency cases, and conversions were excluded. Preoperative and intraoperative factors were examined via univariate analysis. Outcomes were assessed via logistic regression.

Results

Among 1,193,655 surgeries, 1,058,405 were categorized as Black (21%) or white (79%), and 1,081,516 as Hispanic (15%) or non-Hispanic (85%). White patients were more likely to undergo gastric bypass surgery than Black patients (p < 0.01). There were fewer Black males undergoing bariatric surgery than white males (12.68% vs. 20.92%, p < 0.01). Black race correlated with a higher frequency of robotic approaches (14.64% vs. 12.37%, p < 0.01). Black race (also subgroup non-Hispanic black) exhibited higher odds of death (OR 1.64, CI 1.38-1.95, p < 0.01) and increased odds for several adverse outcomes compared to white patients. Hispanic patients demonstrated lower odds of adverse outcomes compared to non-Hispanic patients with the exception of higher readmission.

Conclusions

Black patients had worse 30-day outcomes compared to white patient within the majority of variables. Comorbidities and outcomes were better in the Hispanic group compared to non-Hispanic.