Community-Level Socioeconomic Disadvantage and Adverse Events after Metabolic Surgery Outcomes: A State-Wide Analysis from the Michigan Bariatric Surgery Collaborative

Document Type

Conference Proceeding

Publication Date

11-1-2024

Publication Title

J Am Coll Surg

Keywords

adult, adverse event, aged, bariatric surgery, body mass, Caucasian, cohort analysis, conference abstract, controlled study, diabetes mellitus, disadvantaged population, emergency department visit, female, gastric bypass surgery, hospital readmission, human, major clinical study, male, Michigan, neighborhood, sleeve gastrectomy, social inequality, total quality management

Abstract

Introduction: Patients from socioeconomically disadvantaged communities have been shown to have poorer health-care outcomes. The area deprivation index (ADI) is a validated, composite index that uses zip codes to identify neighborhood-level social disparities. A higher ADI indicates a greater degree of disadvantage. To date, metabolic surgery outcomes according to ADI have not been evaluated. Methods: Using a state-wide bariatric-specific data registry, we obtained state-level ADI (Percentile Rank: 1-10) on all patients who underwent primary metabolic surgery (n = 79,311). Patient characteristics and 30-day risk-adjusted outcomes were compared between patients in the highest and lowest quartile for ADI. Results: Patients in the highest quartile for ADI (mean ADI 9.1) were younger (43.8 years vs 46.5 years, p < 0.0001), had a higher preoperative body mass index (BMI) (49.3 kg/m2 vs 46.6 kg/m2, p < 0.0001) and were more likely to be female (84.4% vs 76.8%, p < 0.0001), non-White (53.9% vs 23.1%, p < 0.0001) and have diabetes (33.6% vs. 30.8%, p < 0.0001) when compared to patients in the lowest quartile (mean ADI 2.2). The highest quartile experienced similar complication rates, emergency room visit rates and readmission rates for both sleeve gastrectomy (5.3% vs 5.5% p = 0.859, 7.6 vs 7.5, p = 0.1071 and 2.7% vs 2.9%, p = 0.7583, respectively) and gastric bypass (12.3% vs 11.2%, p = 0.0637, 11.2% vs 11.1%, p = 0.3013 and 5.5% vs 5.6%, p = 0.6459, respectively). Conclusion: Within the context of a state-wide quality improvement collaborative, adverse events after metabolic surgery are similar between patients living in neighborhoods with high and low ADI in Michigan. Long-term outcomes require further investigation.

Volume

239

Issue

5

First Page

S36

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