Background

Roux-en-Y gastric bypass (RYGB) continues to be safely performed in racial cohorts. However, studies continue to report differences in complications, with black patients having a higher rate of adverse outcomes, including mortality. It is unclear how these disparate outcomes have evolved over time.Objective: To determine RYGB procedure and mortality trends in racial cohortsInstitution: Academic Hospital

Methods

Using the 2015 to 2019 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Project (MBSAQIP) data, we identified primary RYGB cases performed laparoscopically or robotically. White and Black patient cohorts (1:1) matching based upon patient and surgical characteristics. Conditional logistic regression analysis was conducted on the matched pairs. Primary outcomes of interest included year-to-year all-cause and RYGB-related mortality. Secondary outcomes included adverse outcomes in matched cohorts. Stata/MP 16.1 was utilized for analysis and a p-value of < 0.05 and a 95% Confidence Interval that excluded 1 were considered significant.

Results

148,829 RYGB cases in White (83%) and Black (17%) patients were analyzed. RYGB trends remain similar for Black and White patients over 5-years. In matched cohorts, overall mortality (OR 1.94), RYGB-related mortality (OR 2.09), aggregate VTE (OR 1.59), readmission (OR 1.49), reoperation (OR 1.24) and intervention (OR 1.41) were more likely in Black patients (Table 1). During the study period, mortality trends remained steady in White patients and declined in Black patients (Figure 1).

Conclusions

RYGB continue to be underperformed in Black patients. Mortality remains more common on Black patients, with a declining trend over the 5-year study period.