The PCORnet® Bariatric Study has found that there are significant differences in safety and utilization outcomes for Black and Hispanic patients who had Roux-en-Y gastric bypass (bypass) compared with sleeve gastrectomy (gastrectomy). While weight loss and diabetes outcomes were similar across racial and ethnic groups for both bypass and gastrectomy, Black and Hispanic patients had a greater risk of hospitalization and adverse events with bypass surgery, according to the findings published in JAMA Surgery.
However, patients and providers shouldn’t necessarily conclude that gastrectomy is a superior choice of surgery for Black and Hispanic patients, the researchers noted. In fact, previous research conducted by the PCORnet Bariatric Study team found that more patients of all races and ethnicities who had bypass kept weight off five years after surgery than those who underwent gastrectomy. Those who had bypass were also significantly less likely to see a return of obesity-related medical conditions like Type 2 diabetes. The PCORnet Bariatric Study team says that these latest findings point to disparities in pre- and post-operative care rather than differences in the procedures themselves.
“As with many health care options, no one weight-loss surgical procedure is the best choice for every patient because tradeoffs are associated with each,” said Kathleen McTigue, M.D., M.P.H., M.S. “Results of this latest research should serve as a wake-up call for the medical community to identify and eliminate the barriers to safe bariatric surgery so that Black and Hispanic patients have the same experience as others.”
A continuation of important work
The PCORnet Bariatric Study was originally launched in 2016 as a retrospective, observational comparative effectiveness study designed to capture accurate estimates of 1-, 3-, and 5-year benefits and risk of bariatric surgery. Using PCORnet resources, the study team collaborated with 25 health care systems across the U.S. for insights related to more than 60,000 patients.
Of the original 60,000, 36,871 patients who underwent a primary bypass or sleeve gastrectomy between 2005 and 2015 were included in the current study.
“PCORnet has established partnerships across the nation’s leading health systems that allowed us to conduct bariatric research at the largest scale to date with patient data that is secure and fully de-identified,” Kathleen McTigue, M.D., M.P.H., M.S. “Bariatric procedures are only continuing to rise, and patients deserve a complete picture of what to expect. This research is an important piece of that puzzle, and we are looking forward to unlocking more insights in the months to come.”