Comparative analysis of racial disparities between adolescents and adults undergoing bariatric surgery: analysis from...

Metabolic surgery has emerged as a safe and efficacious treatment for adolescents and adults with obesity, although racial disparities exist in the bariatric population.

This study analyzed patient characteristics and perioperative outcomes to determine if racial disparities differ across age groups in Black and White bariatric patients.

U.S. Metabolic and Bariatric Surgery Accreditation and Quality Initiative Program (MBSAQIP) data file.

Adolescents (≤19 years) and adults (>19 years) who underwent primary metabolic and bariatric surgery (MBS) from 2020-2022 were identified in the MBSAQIP data file. Patient characteristics and 30-day outcomes were compared by race and age group.

Two thousand eight hundred twenty-nine adolescents (n = 793, 28% Black) and 434,775 adults (n = 102,973, 23.7% Black) were included. Preoperative median body mass index (BMI) was higher in Black versus White adolescents (48.6 versus 45.4, P < .001) and Black versus White adults (45.3 versus 43.3, P < .001). Co-morbidity burden was similar between Black and White adolescents. Compared to White adults, Black adults had higher rates of diabetes, hypertension, and renal insufficiency, P < .001. Black adolescents (7.1% versus 3.5%) and adults (4.1% versus 3.1%) were less likely to receive perioperative venous thromboembolism (VTE) prophylaxis versus White patients, P < .001. Incidence of postoperative pulmonary embolism (PE) was higher in Black adolescents (.3% versus 0%, P = .02) and adults (.2% versus .09%, P < .001).

Disparities exist for Black adolescents and adults undergoing MBS. While most outcomes were not clinically significantly worse in Black patients, ensuring appropriate VTE prophylaxis is an important modifiable target for improving outcomes.