Examining the Hispanic paradox in bariatric surgery

Area of Science:

• Bariatric Surgery Outcomes
• Health Disparities Research
• Metabolic Health

Background:

• Obesity rates are higher in the Hispanic population compared to non-Hispanic white individuals.
• Hispanic individuals undergo significantly fewer metabolic and bariatric surgery procedures.
• This disparity suggests potential underutilization of effective weight management interventions.

Purpose of the Study:

• To investigate the
• Hispanic paradox
• in the context of metabolic and bariatric surgery.
• To compare preoperative co-morbidities and postoperative outcomes between Hispanic and non-Hispanic patients.
• To analyze procedure-specific outcomes for sleeve gastrectomy and Roux-en-Y gastric bypass.

Main Methods:

• Utilized data from the Metabolic Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) registry (2015-2017).
• Compared Hispanic patients (n=53,353) with non-Hispanic patients (n=335,299) undergoing sleeve gastrectomy or Roux-en-Y gastric bypass.
• Performed univariate and propensity-matched cohort analyses of preoperative and postoperative variables.

Main Results:

• Hispanic patients demonstrated a lower preoperative co-morbidity profile and decreased rates of major and minor postoperative complications.
• In Roux-en-Y gastric bypass, Hispanic patients had lower overall complication rates despite higher leak rates.
• For sleeve gastrectomy, no significant differences in overall complications were observed, with Hispanic patients showing higher venous thromboembolism but lower bleeding rates.

Conclusions:

• Hispanic patients are underrepresented in metabolic and bariatric surgery.
• These patients present with fewer preoperative health issues and experience similar or reduced postoperative complications.
• Findings support the existence of the "Hispanic paradox" in bariatric surgery outcomes.