Background

African American (AA) patients experience a disproportionately higher rate of obesity and account for a lower percentage of bariatric surgeries. The primary aim of this study was to investigate the preoperative characteristics and perioperative outcomes between AA and non-AA patients undergoing biliopancreatic diversion with duodenal switch (BPD/DS).

Methods

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) was analyzed for years 2015 through 2021. Exclusion criteria were applied, and patients were split into two cohorts based on being African American (AA) or non-African American (non-AA). Propensity score matching (PSM) was conducted on 19 covariates to achieve two well-balanced groups.

Results

There were a total of 1,279 AA patients and 9,783 non-AA patients undergoing BPD/DS after applied exclusion criteria. AA patients were more likely to be female (78.0% vs 72.1%;p<0.001), have hypertension (47.4% vs 41.6%;p<0.001), have a higher BMI (55.1 ± 10.6 vs 51.4 ± 9.2;p<0.001), and have an IVC filter present (2.1% vs 1.0%;p<0.001). After PSM, AA patients were found to experience similar rates of perioperative mortality, reintervention, and reoperation, but experienced increased operative times (174.8 ± 70.5 vs 157.3 ± 78.7;p<0.001), readmissions (8.8% vs 5.6%;p=0.003), and outpatient dehydration treatment (5.7% vs 3.2%;p=0.005).

Conclusions

African Americans continue to experience higher rates of obesity and certain postoperative complications after bariatric surgery including the BPD-DS. Further understanding of this disparity is important as the BPD-DS, one of the most effective surgical weight loss options, increases in popularity.