Race and Medicine

Race and Medicine

Source: Badurdeen D, et al. Abstract 2. Presented at: Digestive Disease Week; May 21-24, 2021 (virtual meeting).
Disclosures: Badurdeen reports no relevant disclosures.
May 21, 2021
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Higher serious morbidity, adverse events among Black patients after bariatric surgery

Source: Badurdeen D, et al. Abstract 2. Presented at: Digestive Disease Week; May 21-24, 2021 (virtual meeting).
Disclosures: Badurdeen reports no relevant disclosures.
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Although Black patients had better weight loss outcomes after bariatric surgery, they also had a greater risk for serious morbidity and adverse events, according to data presented at Digestive Disease Week.

“There are racial disparities in bariatric surgery use even though obesity affects Black patients disproportionately,” Dilhana S. Badurdeen, MBBS, MD, ABOM, from John Hopkins Hospital, told Healio Gastroenterology. “Based on our analysis, Black patients have a higher risk for serious morbidity and adverse events regardless of baseline comorbidities, and type of surgery and thus future studies are needed to reduce healthcare disparity.”

Dilhana badurdenn headshot
Dilhana S. Badurdeen

Using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, Badurdeen and colleagues identified 107,449 Black and 341,380 white patients who underwent Roux-en-Y gastric bypass or sleeve gastrectomy procedures between 2015-2019. They determined predictors of serious morbidity and complications with univariate analyses. Multivariate models included variables significantly correlated in univariate analysis.

Study data showed Black patients were slightly younger compared with white patients (42.56 years vs. 45.62 years; P < .001) and fewer Black patients were men (13.1% vs. 22.9%; P < .001).

At the time of surgery, Black patients had a higher BMI than white patients (46.66 kg/m2 vs. 44.72 kg/m2; P < .001). Also, Black patients were less likely to be smokers than white patients (7.8% vs. 8.9%; P < .001).

The mean decrease in BMI was 2.68 kg/m2 in Black patients and 2.53 kg/m2 in white patients at 30 days after Roux-en-Y gastric bypass, and 2.64 kg/m2 vs. 2.55 kg/m2 after sleeve gastrectomy (P < .001 for both surgery types).

According to Badurdeen and colleagues, Black and white patients did not significantly differ regarding surgery characteristics like use of laparoscopic, hand assisted, natural orifice transluminal endoscopic surgery vs. single incision approach. The use of robotic surgery was not a predictor for serious morbidity or adverse events; although, robotic-assisted surgery was used in 10.6% of Black patients compared with 8.9% of white patients.

Predictors for a higher incidence of serious morbidity and adverse events included age, gastroesophageal reflux disease, use of a mobility device, history of myocardial infarction, previous cardiac surgery, hypertension, history of deep venous thrombosis, renal insufficiency, therapeutic anticoagulation, diabetes, chronic obstructive pulmonary disease, history of pulmonary embolism, sleep apnea and use of chronic steroids at baseline.

After correcting for baseline characteristics, type of surgery and the use of a robot, Badurdeen and colleauges found that Black patients still had a 24% higher risk for serious morbidity and adverse events.