Background

Male gender has long been identified as a risk factor for adverse outcomes, including mortality, after RYGB. The objective of this study was to compare short-term outcomes of patients undergoing laparoscopic RYGB based on gender.

Methods

Patients undergoing RYGB in the 2015, 2016 and 2017 MBSAQIP database were propensity matched 1:1 to compare 30-day outcomes between males and females. A total 47,906 patients were included (23,953 Male/23,953 Female).

Results

The overall complication rate was higher in females (11.5% vs. 10. 2% p<.001) with no difference in mortality related to RYGB. No significant differences between gender were seen for organ space SSI or septic shock. Females had significantly more superficial SSIs (p=0.002), UTIs (p<0.001), readmissions (p<.001) and reinterventions (p<.001). Males had significantly more episodes of unplanned intubation (p=0.008) and extended ventilator use (p=0.01), progressive renal insufficiency (p=0.01) and acute renal failure (p =0 .008), cardiac arrest (p=0.005), ICU admission (p<.001) and all-cause 30-day mortality (p=0.038).

Conclusions

Male gender has been identified as a risk factor for adverse events and mortality after RYGB in several risk models, including our own. This matched analysis demonstrates no specific increased mortality risk for males related to bariatric surgery, although the all-cause mortality risk for males is significantly higher. The prevalence of both major and minor complications was mixed between males and females while females had a higher overall complication rate after RYGB. The availability of the MBSAQIP PUF suggests it is time to create risk models for bariatric surgery.