Equitable Access, Lasting Results: The Influence of Socioeconomic Environment on Bariatric Surgery Outcomes

• Published in: Obesity surgery 2024-10
• Main Authors: Sager La Ganga, Carolina, García-Sanz, Iñigo, Carrillo López, Elena, Navas-Moreno, Víctor, Marazuela, Mónica, Gancedo-Quintana, Álvaro, Marín-Campos, Cristina, Carraro, Raffaele, Sebastián-Valles, Fernando
• Format: Article
• Language: English
• ISSN: 0960-8923; 1708-0428; 1708-0428
• DOI: 10.1007/s11695-024-07529-2

Low socioeconomic status (SES) correlates with higher obesity rates and challenges in accessing treatments like bariatric surgery (BS). This study aims to assess SES's influence on medium-term BS outcomes in a setting of universal healthcare, ensuring equitable treatment access. We conducted a retrospective analysis of 193 BS patients (1997-2018) at a tertiary care hospital. Weight loss was expressed as change in % total weight loss (%TWL) and excess body weight (EBW) loss. Successful BS was defined as > 50% EBW loss. SES was gauged using quartiles of the Spanish Deprivation Index. A multivariable Cox regression model evaluated SES impact on BS success over follow-up. The mean follow-up was 6.9 ± 4.6 years; patients averaged 43.9 ± 11.8 years, with 29.7% men. Preoperative BMI was 48.2 ± 8.2 kg/m . At follow-up, BMI was 33.9 ± 6.6 kg/m , with 29.3 ± 12.02% of %TWL. No SES quartile differences in BS success were noted at follow-up (log rank p = 0.960). Cox regression revealed no SES disparities in BS outcomes post-adjustment. However, female sex (HR 1.903; p = 0.009) and diabetes mellitus (HR = 0.504; p = 0.010) correlated with weight-related outcomes. In a universal healthcare system with equitable treatment access, medium-term BS outcomes remain consistent irrespective of patients' socioeconomic status.