Demographically associated variations in outcomes after bariatric surgery

Background: The incidence of morbid obesity and the use of bariatric surgery as a weight loss tool have increased significantly over the past decade. Despite this increase, there has been limited large-scale database evaluation of the effects of demographics on postoperative occurrences. Methods: An analysis of the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2007 was performed. The bariatric procedures identified were open Roux-en-Y gastric bypass, laparoscopic Roux-en-Y gastric bypass, adjustable gastric banding, vertical banded gastroplasty, restrictive procedures other than vertical banded gastroplasty, and biliopancreatic diversion/duodenal switch. Outcomes examined were 30-day mortality and American College of Surgeons National Surgical Quality Improvement Programdefined morbidities. Multivariate analysis was performed. Results: A total of 18,682 bariatric procedures were identified. Increased body mass index, age, and undergoing open Roux-en-Y gastric bypass were associated with increased rates of postoperative complications. Hispanic and African American patients were noted to have increased rates of certain postoperative complications. Conclusions: Demographic factors may influence the postoperative course of patients undergoing bariatric surgery. Prospective studies may further elucidate the associations between demographic factors and specific postoperative complications.