An analysis of readmission trends by urgency and race/ethnicity in the MBSAQIP registry, 2015–2018

O’Neill, Sean M.; Needleman, Bradley; Narula, Vimal K.; Brethauer, Stacy A.; Noria, Sabrena

doi:10.1016/j.soard.2021.10.018

Cited by 8 publications

(2 citation statements)

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“…Higher ED use among Black patients, as well as the higher cumulative incidence of other adverse outcomes among Black patients observed in this study is consistent with prior literature demonstrating worse bariatric surgical outcomes among minority groups. For example, O’Neill et al14 found that Black and Hispanic patients had a higher risk of 30-day readmission after bariatric surgery compared with White patients. Other studies also suggest that minority patients experience worse outcomes after bariatric surgery 13.…”

Section: Discussionmentioning

confidence: 99%

“…This lack of evaluation of patients with Medicaid also impedes our understanding of the comparative risks and benefits of these 2 procedures in minority and vulnerable populations. Although prior work suggests that Black and Hispanic patients may have higher short-term complication rates after bariatric surgery, to date no study has assessed these outcomes in a large sample of Medicaid patients with long-term follow-up 13,14…”

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confidence: 99%

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Comparative Safety of Sleeve Gastrectomy and Gastric Bypass up to 5 Years After Surgery in Patients With Medicaid

et al. 2022

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Objective: Compare adverse outcomes up to 5 years after sleeve gastrectomy and gastric bypass in patients with Medicaid. Background: Sleeve gastrectomy is the most common bariatric operation among patients with Medicaid; however, its long-term safety in this population is unknown. Methods: Using Medicaid claims, we performed a retrospective cohort study of adult patients who underwent sleeve gastrectomy or gastric bypass from January 1, 2012, to December 31, 2018. Instrumental variables survival analysis was used to estimate the cumulative incidence and heterogeneity of outcomes up to 5 years after surgery. Results: Among 132,788 patients with Medicaid, 84,717 (63.8%) underwent sleeve gastrectomy and 48,071 (36.2%) underwent gastric bypass. A total of 69,225 (52.1%) patients were White, 33,833 (25.5%) were Black, and 29,730 (22.4%) were Hispanic. Compared with gastric bypass, sleeve gastrectomy was associated with a lower 5-year cumulative incidence of mortality (1.29% vs 2.15%), complications (11.5% vs 16.2%), hospitalization (43.7% vs 53.7%), emergency department (ED) use (61.6% vs 68.2%), and reoperation (18.5% vs 22.8%), but a higher cumulative incidence of revision (3.3% vs 2.0%). Compared with White patients, the magnitude of the difference between sleeve and bypass was smaller among Black patients for ED use [5-y adjusted hazard ratios: 1.01; 95% confidence interval (CI), 0.94-1.08 vs 0.94 (95% CI, 0.88-1.00), P < 0.001] and Hispanic patients for reoperation [5-y adjusted hazard ratios: 0.95 (95% CI, 0.86-1.05) vs 0.76 (95% CI, 0.69-0.83), P < 0.001].Conclusions: Among patients with Medicaid undergoing bariatric surgery, sleeve gastrectomy was associated with a lower risk of mortality, complications, hospitalization, ED use, and reoperations, but a higher risk of revision compared with gastric bypass. Although the difference between sleeve and bypass was generally similar among White, Black, and Hispanic patients, the magnitude of this difference was smaller among Black patients for ED use and Hispanic patients for reoperation.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%