Differences in Post-Surgical Outcomes and Complications Among Males and Females Undergoing Bariatric Surgery: A State-wide Analysis

Document Type

Conference Proceeding

Publication Date

6-7-2023

Publication Title

Surg Endosc

Abstract

Introduction: Sex as a biologic variable remains largely understudied, even for the most commonly performed operations. Bariatric surgery is one of the most commonly performed operations in the USA and is the most effective treatment for obesity and obesityassociated comorbidities. However, there is scant data to describe potential differences in outcomes between male and female patients, particularly with regards to weight loss. Within this context, we examined weight loss and complications up to one year following sleeve gastrectomy or gastric bypass within a state-wide bariatric quality improvement collaborative. Methods and Procedures: We performed a retrospective cohort study among patients who had bariatric surgery. Using a state-wide bariatric-specific data registry, all patients who underwent gastric bypass or sleeve gastrectomy between June 2006 and June 2022 were identified. The primary outcome was total body weight loss, percent total body weight loss, and body mass index at one year. The secondary outcome was the adjusted risk of 30-day complications. We used multivariable linear regression models to estimate weight loss and BMI, and multivariable logistic regression models to estimate overall risk of complications. Results: Among 107,504 patients, the majority (n = 85,135; 79.2%) were female and most patients (n = 49,731; 58%) underwent sleeve gastrectomy. Compared to female patients, male patients were older (47.6 yrs vs 44.8 yrs; p<0.0001), had higher baseline weight (346.6 lbs vs 279.9 lbs; p<0.0001), had higher preoperative BMI (49.9 kg/m2 vs 47.2 kg/m2; p<0.0001), and higher prevalence of most comorbid conditions, including hypertension, hyperlipidemia, diabetes, and sleep apnea (p<0.0001). Compared to females patients, male patients experienced greater total body weight loss (105.1 lbs vs 84.9 lbs; p<0.0001) and higher excess body weight loss (60.0% vs 58.8%; p<0.0001) but had higher BMI overall (34.0 kg/m2 vs 32.8 kg/m2; p<0.0001) at one year of follow-up. Compared to females, males had higher rates of 30-day complications, including serious complications (2.5% vs 1.9%; p<0.0001). Conclusion: In this study we found that both males and females experienced excellent weight loss with a low risk of complications following bariatric surgery. However, male sex was associated with slightly greater weight loss and slightly higher incidence of complications. Providers should consider referring males earlier for bariatric surgery which may improve outcomes for this population.

Volume

37

First Page

S392

Last Page

S393

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