Background

The Distressed Communities Index (DCI) compiles social and economic factors of a zip code into a single numerical score from 0 to 100. High DCI has been associated with decreased access to care and adverse surgical outcomes. We assessed the impact of DCI on outcomes and health care utilization rates after bariatric surgery.

Methods

The MBSAQIP database was queried for patients who underwent bariatric surgery at two surgical centers within a health system from Jan 2020 to June 2022. Patients over 18 who underwent primary bariatric surgery were included. A DCI value was extracted for each patient’s ZIP code. Student’s t-test, Wilcoxon Rank Sum Test, and Chi-square test were used as appropriate. Pearson’s correlation was used to look for adverse outcomes and utilization rates. A p value <0.05 was deemed significant.

Results

A total of 1,576 patients were identified, with 88% female, mean age 43.2 years (SD 11.7). Laparoscopic sleeve gastrectomies accounted for 47.6% of cases, while 52.4% underwent laparoscopic Roux-en-y gastric bypass. Mean DCI was 51.9 (SD 27.8, range 0.4-99.4), from 221 zip codes. There was no correlation between DCI and emergency department visits (12.4% P>0.2), postoperative complications (3.9% P>0.08), or readmissions (5.6%, p>0.19). There was no correlation between DCI and BMI change at 6 months or at 1 year (correlation coefficient -0.060, -0.062 respectively) (Figure 1).

Conclusions

No correlation was found between DCI and outcomes after bariatric surgery in this population. Prospective patients seeking bariatric surgery should not be deemed poor candidates based on their socioeconomic status.