Racial differences among patients undergoing laparoscopic gastric bypass surgery: A population-based trend analysis from 2002 to 2008

Mathias Worni, Ulrich Guller, Matthew L. MacIejewski, Lesley H. Curtis, Mihir Gandhi, Ricardo Pietrobon, Danny O. Jacobs, Truls Østbye

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Laparoscopic gastric bypass surgery (LGBS) has become the most widely used bariatric procedure due to its beneficial long-term outcomes for patients with morbid obesity. However, it is unclear whether racial differences in admission for LGBS have changed over time compared to racial differences in all other admissions. We aimed to investigate the trends and differences in the use of LGBS among white, African-American, and Hispanic patients from 2002 to 2008. Methods: We performed a secondary analysis of data on obese adult patients operated between 2002 and 2008, using the Nationwide Inpatient Sample (NIS) database. The probability of being admitted for LGBS was estimated using logistic regression with race, year, and year by race interaction as predictors, controlling for numerous patient and hospital characteristics. Results: Among 1,704,972 obese hospitalized patients captured through NIS from 2002 to 2008, 2.6 % underwent LGBS (2.8 % Whites, 1.7 % African-Americans, and 2.6 % Hispanics). In adjusted analysis, obese African-American (OR 0.48, p < 0.001) and Hispanic patients (OR 0.59, p < 0.001) were less likely to be admitted for LGBS than white patients in 2002. Race-year interactions showed that the odds of African-Americans undergoing LGBS significantly increased from 2002 to 2008 compared with Whites (annual OR 1.03, p < 0.001) while no such increase was detected for Hispanics (annual OR 1.02, p = 0.11). In 2008, African-American (OR 0.58, p < 0.001) and Hispanic patients (OR 0.65, p < 0.001) still had lower odds than white patients. Conclusions: This is the first study showing that the difference in the use of LGBS between obese African-American and white patients declined between 2002 and 2008. However, LGBS use still remained significantly lower for both African-American and Hispanic patients in 2008 compared with white patients.

Original languageEnglish (US)
Pages (from-to)226-233
Number of pages8
JournalObesity Surgery
Volume23
Issue number2
DOIs
StatePublished - Feb 2013
Externally publishedYes

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Gastric Bypass
African Americans
Hispanic Americans
Population
Inpatients
Bariatrics
Morbid Obesity
Logistic Models
Databases

Keywords

  • Bariatric surgery
  • Disparity
  • Ethnicity
  • Laparoscopic gastric bypass
  • Race

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Worni, M., Guller, U., MacIejewski, M. L., Curtis, L. H., Gandhi, M., Pietrobon, R., ... Østbye, T. (2013). Racial differences among patients undergoing laparoscopic gastric bypass surgery: A population-based trend analysis from 2002 to 2008. Obesity Surgery, 23(2), 226-233. https://doi.org/10.1007/s11695-012-0832-8

Racial differences among patients undergoing laparoscopic gastric bypass surgery : A population-based trend analysis from 2002 to 2008. / Worni, Mathias; Guller, Ulrich; MacIejewski, Matthew L.; Curtis, Lesley H.; Gandhi, Mihir; Pietrobon, Ricardo; Jacobs, Danny O.; Østbye, Truls.

In: Obesity Surgery, Vol. 23, No. 2, 02.2013, p. 226-233.

Research output: Contribution to journalArticle

Worni, M, Guller, U, MacIejewski, ML, Curtis, LH, Gandhi, M, Pietrobon, R, Jacobs, DO & Østbye, T 2013, 'Racial differences among patients undergoing laparoscopic gastric bypass surgery: A population-based trend analysis from 2002 to 2008', Obesity Surgery, vol. 23, no. 2, pp. 226-233. https://doi.org/10.1007/s11695-012-0832-8
Worni, Mathias ; Guller, Ulrich ; MacIejewski, Matthew L. ; Curtis, Lesley H. ; Gandhi, Mihir ; Pietrobon, Ricardo ; Jacobs, Danny O. ; Østbye, Truls. / Racial differences among patients undergoing laparoscopic gastric bypass surgery : A population-based trend analysis from 2002 to 2008. In: Obesity Surgery. 2013 ; Vol. 23, No. 2. pp. 226-233.
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abstract = "Background: Laparoscopic gastric bypass surgery (LGBS) has become the most widely used bariatric procedure due to its beneficial long-term outcomes for patients with morbid obesity. However, it is unclear whether racial differences in admission for LGBS have changed over time compared to racial differences in all other admissions. We aimed to investigate the trends and differences in the use of LGBS among white, African-American, and Hispanic patients from 2002 to 2008. Methods: We performed a secondary analysis of data on obese adult patients operated between 2002 and 2008, using the Nationwide Inpatient Sample (NIS) database. The probability of being admitted for LGBS was estimated using logistic regression with race, year, and year by race interaction as predictors, controlling for numerous patient and hospital characteristics. Results: Among 1,704,972 obese hospitalized patients captured through NIS from 2002 to 2008, 2.6 {\%} underwent LGBS (2.8 {\%} Whites, 1.7 {\%} African-Americans, and 2.6 {\%} Hispanics). In adjusted analysis, obese African-American (OR 0.48, p < 0.001) and Hispanic patients (OR 0.59, p < 0.001) were less likely to be admitted for LGBS than white patients in 2002. Race-year interactions showed that the odds of African-Americans undergoing LGBS significantly increased from 2002 to 2008 compared with Whites (annual OR 1.03, p < 0.001) while no such increase was detected for Hispanics (annual OR 1.02, p = 0.11). In 2008, African-American (OR 0.58, p < 0.001) and Hispanic patients (OR 0.65, p < 0.001) still had lower odds than white patients. Conclusions: This is the first study showing that the difference in the use of LGBS between obese African-American and white patients declined between 2002 and 2008. However, LGBS use still remained significantly lower for both African-American and Hispanic patients in 2008 compared with white patients.",
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