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Racial disparities in mortality in patients undergoing bariatric surgery in the U.S.A.
Obes Surg. 2013 Oct; 23(10):1508-14.OS

Abstract

BACKGROUND

Non-Hispanic blacks bear a disproportionate burden of the growing obesity epidemic. Bariatric surgery is an effective treatment for morbid obesity. We sought to assess for racial disparities in short-term outcomes following bariatric surgery.

METHODS

Patients undergoing bariatric surgery were extracted from the Nationwide Inpatient Sample between 1999 and 2007. In-hospital mortality and length of stay were compared between different racial groups undergoing bariatric surgery after stratification by gender, and multivariate analysis was conducted to adjust for demographic, surgery year, and clinical and hospital characteristics.

RESULTS

There were 115,507 bariatric surgeries. Overall mortality rate was 2.5 deaths per 1,000 and was higher among non-Hispanic blacks compared to non-Hispanic whites (3.7 vs. 2.3 per 1,000; P = 0.007). Racial mortality disparities were most pronounced among males and at hospitals with lowest surgical volumes. In multivariate analysis, predictors of mortality were non-Hispanic black race (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.22-2.45), increasing age, increasing Charlson index (OR, 1.26; 95% CI, 1.16-1.37), Medicare (OR, 2.13; 95% CI, 1.57-2.91), and Medicaid (OR, 3.35; 95% CI, 2.29-4.91) insurance. Incremental calendar year had reduced odds of mortality (OR, 0.80; 95% CI, 0.76-0.83). Above national median neighborhood income (OR, 0.59; 95% CI, 0.42-0.83) was protective in males, while teaching hospital status conveyed greater mortality (OR, 2.12; 95% CI, 1.40-3.22).

CONCLUSIONS

Non-Hispanic blacks undergoing bariatric surgery demonstrate higher in-hospital mortality than their racial counterparts. It is unclear if this disparity is due to susceptibility to obesity-related mortality or suboptimal delivery of healthcare in the perioperative setting.

Authors+Show Affiliations

Division of Gastroenterology, Mount Sinai Hospital, University of Toronto, 600 University Avenue, Suite 437, Toronto, Ontario, Canada, M5G 1X5, geoff.nguyen@utoronto.ca.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23595211

Citation

Nguyen, Geoffrey C., and Akash M. Patel. "Racial Disparities in Mortality in Patients Undergoing Bariatric Surgery in the U.S.A." Obesity Surgery, vol. 23, no. 10, 2013, pp. 1508-14.
Nguyen GC, Patel AM. Racial disparities in mortality in patients undergoing bariatric surgery in the U.S.A. Obes Surg. 2013;23(10):1508-14.
Nguyen, G. C., & Patel, A. M. (2013). Racial disparities in mortality in patients undergoing bariatric surgery in the U.S.A. Obesity Surgery, 23(10), 1508-14. https://doi.org/10.1007/s11695-013-0957-4
Nguyen GC, Patel AM. Racial Disparities in Mortality in Patients Undergoing Bariatric Surgery in the U.S.A. Obes Surg. 2013;23(10):1508-14. PubMed PMID: 23595211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial disparities in mortality in patients undergoing bariatric surgery in the U.S.A. AU - Nguyen,Geoffrey C, AU - Patel,Akash M, PY - 2013/4/19/entrez PY - 2013/4/19/pubmed PY - 2014/5/6/medline SP - 1508 EP - 14 JF - Obesity surgery JO - Obes Surg VL - 23 IS - 10 N2 - BACKGROUND: Non-Hispanic blacks bear a disproportionate burden of the growing obesity epidemic. Bariatric surgery is an effective treatment for morbid obesity. We sought to assess for racial disparities in short-term outcomes following bariatric surgery. METHODS: Patients undergoing bariatric surgery were extracted from the Nationwide Inpatient Sample between 1999 and 2007. In-hospital mortality and length of stay were compared between different racial groups undergoing bariatric surgery after stratification by gender, and multivariate analysis was conducted to adjust for demographic, surgery year, and clinical and hospital characteristics. RESULTS: There were 115,507 bariatric surgeries. Overall mortality rate was 2.5 deaths per 1,000 and was higher among non-Hispanic blacks compared to non-Hispanic whites (3.7 vs. 2.3 per 1,000; P = 0.007). Racial mortality disparities were most pronounced among males and at hospitals with lowest surgical volumes. In multivariate analysis, predictors of mortality were non-Hispanic black race (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.22-2.45), increasing age, increasing Charlson index (OR, 1.26; 95% CI, 1.16-1.37), Medicare (OR, 2.13; 95% CI, 1.57-2.91), and Medicaid (OR, 3.35; 95% CI, 2.29-4.91) insurance. Incremental calendar year had reduced odds of mortality (OR, 0.80; 95% CI, 0.76-0.83). Above national median neighborhood income (OR, 0.59; 95% CI, 0.42-0.83) was protective in males, while teaching hospital status conveyed greater mortality (OR, 2.12; 95% CI, 1.40-3.22). CONCLUSIONS: Non-Hispanic blacks undergoing bariatric surgery demonstrate higher in-hospital mortality than their racial counterparts. It is unclear if this disparity is due to susceptibility to obesity-related mortality or suboptimal delivery of healthcare in the perioperative setting. SN - 1708-0428 UR - https://www.unboundmedicine.com/medline/citation/23595211/Racial_disparities_in_mortality_in_patients_undergoing_bariatric_surgery_in_the_U_S_A_ L2 - https://dx.doi.org/10.1007/s11695-013-0957-4 DB - PRIME DP - Unbound Medicine ER -