Exploring racial disparity in perioperative outcomes following revisional bariatric surgery: A case-control matched analysis

Introduction: Bariatric surgery is associated with 20-30% weight recidivism. As a result, revisional bariatric operation is increasingly performed. Disparity in bariatric outcomes remains controversial and very little is known about revisional bariatric surgery outcomes in ethnic cohorts. Methods: Revisional bariatric cases were identified from the 2015 and 2016 Bariatric Surgery Accreditation and Quality Improvement Program Participant Use Data File. 1:1 case-control matching was performed and perioperative outcomes compared between racial cohorts. Results: 24,197 cases were analyzed, including 20.78% Black patients. At baseline, there were differences in demographics and pre-existing conditions between racial cohorts. Matched analysis compared 7,286 Black and White patients. Operative duration (p = 0.008) and length of stay (p = 0.0003) were longer in Black patients. Readmission (6.8% vs. 5.4%, p = 0.009) was higher in Black patients. Bleeding (0.82% vs. 0.38%, p = 0.02) and surgical site infection (SSI) (2.6% vs. 1.8%, p = 0.01) were higher in White patients. Conclusion: Revisional bariatric surgery is safe. Apart from a higher rate of bleeding, SSI and readmission, outcomes were not mediated by race. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

Revisional bariatric surgery is found to be safe overall, but significant differences were observed in operative duration, length of stay, and readmission rate among Black patients. White patients had a higher risk of bleeding and surgical site infection.