Racial and Ethnic Disparities in Causes for Reoperation and Reintervention Following Bariatric Surgery

Obesity is an epidemic that affects individuals of all races. Literature reports reoperation rates from 0.1 to 6.5% and non-operative reintervention rates from 1.1 to 3.6% after metabolic and bariatric surgery (MBS). Despite discordant rates among ethnic groups being described, results are still inconclusive.

To compare reoperation and reintervention causes among ethnic MBS cohorts (setting-Academic Hospital).

Roux-en-Y Gastric Bypass (RYGB) and sleeve gastrectomy (SG) cases were identified from the 2015-2018 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Project (MBSAQIP) databases. Regression analyses were performed to determine predictors of reoperation and reintervention. Reoperation and reintervention causes were compared among racial/ethnic cohorts using Pearson chi-square or Kruskal-Wallis tests. A p-value < 0.05 was considered significant.

In total, 550,671 cases were analyzed. Reoperation and reintervention rates for all-cause and bariatric-related causes were 1.3%, 1.05%, 1.3%, and 1.2%, respectively. The NHB population was identified as an independent predictor of reoperation and reintervention. The most common bariatric-related causes of reoperation were bleeding (22.67%) and leaks (18.07%). NHB had an increased proportion of reoperation due to IO and reintervention due to NVP. For Hispanics and NHW, an increased proportion of bleeding and leaks were significantly increased for both reoperation and reintervention, respectively. After propensity matching, NHB patients undergoing SG had higher odds of reoperation and reintervention due to leaks and bleeding compared to other populations.

MBS reoperation and reintervention causes differ by ethnic groups. Studies on optimizing care quality based on these disparities should be conducted.