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Impact of Racial Disparities in Preoperative Cardiovascular Evaluation and Surgical Outcomes in Patients Undergoing Metabolic and Bariatric Surgery: A Retrospective Cohort Analysis
Ibrahim, Kaitlyn D. Tragesser, Lauren A. Soans, Rohit Haddad, Abdullah Eddy, Vikram J. McComb, Joseph Keane, Martin G. Whitman, Isaac R.
Ibrahim, Kaitlyn D.
Tragesser, Lauren A.
Soans, Rohit
Haddad, Abdullah
Eddy, Vikram J.
McComb, Joseph
Keane, Martin G.
Whitman, Isaac R.
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Journal article
Date
2022-05-27
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Medicine
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http://dx.doi.org/10.1161/jaha.121.024499
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/m2 versus 12.0 kg/m2, P=0.0289), but equivalent at 1 year (14.9 kg/m2 versus 14.3 kg/m2, 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.
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Impact of Racial Disparities in Preoperative Cardiovascular Evaluation and Surgical Outcomes in Patients Undergoing Metabolic and Bariatric Surgery: A Retrospective Cohort Analysis Kaitlyn D. Ibrahim MD , Lauren A. Tragesser MD , Rohit Soans MD , Abdullah Haddad MD, MPH , Vikram J. Eddy MD , Joseph McComb DO , Martin G. Keane MD , and Isaac R. Whitman MD isaac.whitman@tuhs.temple.edu
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Wiley Open Access
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Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease (JAHA), Vol. 11, Iss. 11
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