Background

The rates of postoperative complications can vary among specific patient populations. The aim of this study is to examine how gender, race and ethnicity can affect short-term postoperative complications in bariatric surgery patients.

Methods

Patients who underwent bariatric surgery between the years 2015-2021 were included and stratified based on gender, race/ethnicity, and procedure type. The 30-day outcomes were assessed using Clavien-Dindo (CD) classification of III-V. Wilcoxon rank-sum test was performed to compare continuous variables among groups and Chi-squared test for categorical variables. Logistic regression was carried out to identify predictors of CD classification ≥ III complications.

Results

A total of 1,346,468 bariatric surgery patients were included. Analysis showed that CD≥III complications were higher among African Americans and lowest in Hispanic patients regardless of their gender. Male patients had a higher risk of complications than females. Sleeve gastrectomy showed the lowest complication rates followed by gastric bypass and duodenal switch in all groups (Table 1). In logistic regression, African Americans had higher odds of postoperative complications compared to Whites in sleeve gastrectomy (p < 0.0001) and gastric bypass (p <0.002).

Conclusions

Our findings validate previous studies that gender, race/ethnicity, and procedure type are important determinants of postoperative outcomes in bariatric surgery. Male gender increases risk of serious postoperative complications. African Americans had the worst outcomes while Hispanic patients had the lowest rate of CD ≥ III complications regardless of gender or procedure type. Sleeve gastrectomy is the safest among common bariatric surgery procedures.