The impact of the COVID-19 pandemic on racial disparities in postoperative outcomes after bariatric surgery.

Autor:	Ottaviano K; Department of Surgery, Albany Medical Center, Albany, NY, United States., Booras A; Department of Surgery, Albany Medical Center, Albany, NY, United States., Ashar Z; Department of Surgery, Albany Medical Center, Albany, NY, United States., Ata A; Department of Surgery, Albany Medical Center, Albany, NY, United States., Singh TP; Department of Surgery, Albany Medical Center, Albany, NY, United States., Zaman JA; Department of Surgery, Albany Medical Center, Albany, NY, United States. Electronic address: zamanj@amc.edu.
Jazyk:	angličtina
Zdroj:	Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2024 Dec; Vol. 28 (12), pp. 2106-2112. Date of Electronic Publication: 2024 Oct 16.
DOI:	10.1016/j.gassur.2024.09.023
Abstrakt:	Background: The COVID-19 pandemic has affected the outcomes and access to elective surgery across the United States. This study hypothesized that preexisting racial and ethnic disparities were exacerbated by the pandemic for bariatric surgery. Methods: This retrospective cohort study evaluated the outcome disparities in 1,046,578 patients who underwent bariatric surgery from 2016-2019 (before the COVID-19 pandemic) to 2020-2021 (during the COVID-19 pandemic) using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. The primary outcomes of interest, Clavien-Dindo (CD) scores (0-5) and extended length of stay (eLOS; >90th percentile), were compared between non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic, and non-Hispanic Asian/American Indian/Pacific Islander (A/AI/PI) patients using ordinal and binomial logistic regression models, respectively. In addition, the modifying effect of COVID-19 on racial disparities in these outcomes was assessed. Results: Overall, patients during the COVID-19 pandemic had higher odds of a higher CD score (odds ratio [OR], 1.05; 95% CI, 1.04-1.06; P < .001) than patients before the COVID-19 pandemic on adjusted multivariate analysis. NHB patients were more likely to experience postoperative complications as characterized by higher CD scores (OR, 1.37; 95% CI, 1.35-1.39; P < .001) than NHW patients, and COVID-19 was a contributory factor (ratio of ORs, 1.07; 95% CI, 1.05-1.10). There was no significant difference in CD scores in Hispanic (OR, 1.00; 95% CI, 0.98-1.03; P = .800) and A/AI/PI (OR, 0.98; 95% CI, 0.92-1.06; P = .651) patients compared with NHW patients, and COVID-19 did not have a modifying effect on these patients. All non-White patients had a higher likelihood of eLOS before the COVID-19 pandemic, but COVID-19 had a modifying effect of decreased odds of eLOS for all races (ratio of ORs, 0.60-0.69; 95% CI, 0.56-0.80). Discussion: NHB patients had inferior perioperative outcomes than patients of other races after bariatric surgery during the COVID-19 pandemic. In addition, all races/ethnicities had decreased odds of eLOS during the COVID-19 pandemic. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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