Impact of Racial Disparities in Preoperative Cardiovascular Evaluation and Surgical Outcomes in Patients Undergoing Metabolic and Bariatric Surgery: A Retrospective Cohort Analysis

Author:

Ibrahim Kaitlyn D.123ORCID,Tragesser Lauren A.1,Soans Rohit14,Haddad Abdullah12,Eddy Vikram J.14,McComb Joseph15,Keane Martin G.12,Whitman Isaac R.12ORCID

Affiliation:

1. Lewis Katz School of Medicine at Temple University Philadelphia PA

2. Division of Cardiology Temple University Hospital Philadelphia PA

3. Main Line Health Broomall PA

4. Division of Bariatric Surgery Temple University Hospital Philadelphia PA

5. Division of Anesthesiology Temple University Hospital Philadelphia PA

Abstract

Background We investigated preoperative referral patterns, rates of cardiovascular testing, surgical wait times, and postoperative outcomes in White versus Black, Hispanic, or other racial or ethnic groups of patients undergoing metabolic and bariatric surgery. Methods and Results This was a single center retrospective cohort analysis of 797 consecutive patients undergoing metabolic and bariatric surgery from January 2014 to December 2018; 86% (n=682) were Black, Hispanic, or other racial or ethnic groups. White versus Black, Hispanic, or other racial or ethnic groups had similar baseline comorbidities and were referred for preoperative cardiovascular evaluation in similar proportion (65% versus 68%, P =0.529). Black, Hispanic, or other racial or ethnic groups of patients were less likely to undergo preoperative cardiovascular testing (unadjusted odds ratio [OR], 0.56; 95% CI, 0.33–0.95; P =0.031; adjusted for Revised Cardiac Risk Index OR, 0.59; 95% CI, 0.35–0.996; P =0.049). White patients had a shorter wait time for surgery (unadjusted hazard ratio [HR], 0.7; 95% CI, 0.58–0.87; P =0.001; adjusted HR, 0.7; 95% CI, 0.56–0.95; P =0.018). Reduction in body mass index at 6 months was greater in White patients (12.9 kg/m 2 versus 12.0 kg/m 2 , P =0.0289), but equivalent at 1 year (14.9 kg/m 2 versus 14.3 kg/m 2 , P =0.330). Conclusions White versus Black, Hispanic, or other racial or ethnic groups of patients were referred for preoperative cardiovascular evaluation in similar proportion. White patients underwent more preoperative cardiac testing yet had a shorter wait time for surgery. Early weight loss was greater in White patients, but equivalent between groups at 12 months.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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