The effect of sociodemographic factors on outcomes and time to discharge after bariatric operations

• Published in: The American journal of surgery 2020-04, Vol.219 (4), p.571-577
• Main Authors: Guerra, Mary Elizabeth, Jean, Raymond A., Chiu, Alexander S., Johnson, Dirk C.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Age Factors; Bariatric surgery; Body weight loss; Codes; Comorbidity; Continental Population Groups - statistics & numerical data; Datasets as Topic; Disparities; Female; Financing, Personal - statistics & numerical data; Gastrectomy; Gastrectomy - trends; Gastric bypass; Gastric Bypass - trends; Gastrointestinal surgery; Hispanic people; Hospital Mortality; Hospitals; Humans; Income - statistics & numerical data; Insurance Coverage - statistics & numerical data; Length of Stay - statistics & numerical data; Male; Medicaid; Medicaid - statistics & numerical data; Medically Uninsured - statistics & numerical data; Medicare; Medicare - statistics & numerical data; Middle Aged; Mortality; Obesity; Outcomes; Overweight; Patient Discharge - statistics & numerical data; Patients; Postoperative period; Private Sector; Race Factors; Sex Factors; Sociodemographic; Sociodemographics; Socioeconomic; Studies; Surgery; Trends; United States - epidemiology; Variables; Weight control; Weight loss; Weight reduction; Young Adult
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2020.02.046

Bariatric surgery is an effective treatment for obesity resulting in both sustained weight loss and reduction in obesity-related comorbidities. It is uncertain how sociodemographic factors affect postoperative outcomes. The National Inpatient Sample was queried for patients undergoing Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) from 2005 to 2014. Factors associated with selection of SG over RYGB, increased postoperative length of stay (LOS) greater than 3 days, and inpatient mortality were compared by race, insurance status, and other clinical and hospital factors. The database captured 781,413 patients, of which 525,986 had a RYGB and 255,428 had SG. There was an increase in the incidence of SG over RYGB over time. Among the self-pay/uninsured, the increased incidence began several years earlier than other groups. Black patients had greater odds of increased postoperative LOS (OR 1.40) and in-hospital mortality (OR 2.11). Sociodemographic factors are associated with differences in temporal trends in the adoption of SG versus RYGB for surgical weight loss. •The database captured 781,413 discharges during the study period: 525,986 had a RYGB and 255,428 had SG.•There was a substantial increase in the incidence of SG over RYGB, from 3% in 2005 to 59% in 2014.•Among the self-pay/uninsured, the increase began from as early as 2007, before all others.•Blacks had greater odds of increased postoperative LOS greater than 3 days and in-hospital mortality.