Background

Metabolic and bariatric surgery (MBS) is increasingly performed in elderly patients (age ≥ 65 years) with equivocal reported outcomes. Controversy about racial disparity in outcomes following MBS also remain. MBS outcomes in elderly, racial cohorts remain unexplored. We seek todetermine if Black Race independently predicts adverse outcomes in elderly, MBS patients.

Methods

Primary sleeve (SG) and gastric bypass (RnYGB) cases were identified from the 2015-2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Those age ≥ 65 years were included and stratified by race (Black vs. White). Univariate and multivariate logistic regression analysis were performed, comparing descriptive statistics and outcomes in Black and White elderly MBS cohorts.

Results

23,979 MBS cases were performed in elderly Black (8.9%) and White (91.1%) patients. Black patients were more likely to be female, younger, with a higher BMI and receive SG and robotic-assisted surgery. Black patients had a higher prevalence of hypertension, diabetes, renal disease, steroid use, smoking, IVC filter use and prior organ transplantation (Table 1). Outcomes were similar between racial cohorts, except for higher rates of aggregate renal complications (p=0.019), overall (p=0.005), related morbidity (p=0.035) in Black patients. On multivariate analysis, Black Race was an independent predictor of adverse outcomes (p = 0.038); however, RnYGB most predictive of adverse outcomes (Wald 180.8, p < 0.0001).

Conclusions

Being black is an independent predictor of adverse outcomes following MBS in elderly patients. Despite this, the absolute risk of adverse outcomes in elderly racial MBS cohorts remains very low.