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

Am J Surg. 2021 Apr;221(4):741-748. doi: 10.1016/j.amjsurg.2020.03.030. Epub 2020 Apr 3.


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.

Keywords: Disparity; Perioperative outcomes; Revisional bariatric surgery.

MeSH terms

  • Bariatric Surgery*
  • Black or African American*
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / ethnology*
  • Obesity, Morbid / surgery*
  • Reoperation / statistics & numerical data*
  • White People*