M. S. Pichardo2,4, G. Ortega3, E. S. Bauer3, S. Timberline2, M. F. Nunes3, E. Smith2, D. Tran5, T. M. Fullum5 2Howard University College Of Medicine,Washington, DC, USA 3Howard University College Of Medicine,Clive O. Callender Howard-Harvard Health Sciences Outcomes Research Center,Washington, DC, USA 4Yale School Of Public Health,Department Of Chronic Disease Epidemiology,New Haven, CT, USA 5Howard University Hospital,Center For Wellness And Weight Loss Surgery, Department Of Surgery,Washington, DC, USA
Introduction:
Bariatric surgery remains the standard treatment for long-term weight loss and resolution of co-morbidities. Data on post-operative outcomes in Black patients are sparse. This study aims to evaluate the impact of bariatric surgery on weight loss and resolution of co-morbidities in a Black patient population.
Methods:
This is a retrospective review of 592 patients whom underwent weight loss surgery between August 2008 to June 2013. Outcomes of interest included mean weight loss, percent excess weight loss (%EWL), BMI point difference, and resolution of co-morbidities. Unadjusted analysis was performed to compare pre- and post-operative characteristics between laparoscopic roux-en-y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). Adjusted multivariable regression analysis estimated the association between outcomes of interest comparing the two surgical procedures.
Results:
Of 413 Black patients included in the final analysis, most were female (82%) and had a mean age of 43 (standard deviation (SD)=10.7). More than half of patients underwent LRYGB (67%). In unadjusted analysis, at baseline, patients undergoing LRYGB had a greater body weight (308.65 (SD=63.67) vs 289.78 (SD=69.53), p=.006) and BMI (50.05 (SD=9.32) vs 46.77 (SD=8.91), p<.001) and a greater proportion of diabetes (38.99% vs 25.00%, p=.005) and hypertension (77.26% vs 66.18, p=.016) compared to patients who underwent LSG. At 12 months, there were no statistical significant differences between LRYGB and LSG in weight loss (219.61 (SD=55.25) vs 228.59 (SD=63.85), p=.282), BMI points loss (-8.89 (SD=75.97) vs. -9.23 (SD=4.65), p=.473), nor resolution of diabetes (52.78% vs 35.29%, p=.075), hypertension (37.38% vs 27.78%, p=.108) or hypercholesterolemia (58.33% vs 43.75%, p=.159). Percent excess weight loss was significantly higher among LRYGB (mean=29.36, SD=6.66) when compared to LSG (mean=20.07, SD=9.65, p<.001). In multivariable regression analysis, no statistical significant differences were observed between LRYGB and LSG in BMI points loss (β=3.01, 95%CI=-15.79 – 21.82) nor resolution of diabetes (OR=2.11, 95%CI=.92 – 2.86), hypertension (OR=1.54, 95%CI=.88 – 2.70) or hypercholesterolemia (OR=1.97, 95%CI=.81- 4.79). Percent excess weight loss was found to be higher with LRYGB (β=9.76, 95%CI=7.55 – 11.98) compared to LSG.
Conclusion:
Black patients who underwent bariatric surgery experienced successful excess weight loss and resolution of co-morbidities at 12 months. Patients undergoing LRYGB demonstrated greater percent excess weight loss than their LSG counterparts. Both LRYGB and LSG had similar effects in achieving the resolution of co-morbidities.