Pre-Operative Clinical Characteristics Vary by Race in Patients with Obesity Undergoing Bariatric Surgery

Background Data and Purpose: With the increasing prevalence of obesity, it impacts the practice of surgeons across various specialties. Non-bariatric surgeons are confronted with morbid obesity need clinical insight in managing medically fragile patients. The objective of this study is to identify pre-operative clinical variation by race among surgical patients with obesity. Methods: Pre-operative data from 156,502 bariatric surgery patients were analyzed in four groups: Caucasian (C; n=125,492), African American (AA; n=18,226), Hispanic (H; n=12,405), and Asian (A; n=379). Data: Demographics, weight, BMI, and 33 obesity co-morbidities. Statistics: Chi-square and ANOVA. Results: Pre-operative C/AA/H/A weight (KG) (130+-27/135+-28/127+-27/122+-26), BMI (46+-8/48+-9/47+-8/45+-7), % female (77/86/77/73), % >50 years old (39/24/20/21), and unemployment (26/23/24/18) varied by race (p<0.0001). 33 co-morbidities and unemployment varied by race. C had highest gastroesophageal reflux (GERD), ischemic heart disease (IHD), obesity hypoventilation (OHS), sleep apnea (OSA), peripheral vascular disease (PVD), leg edema (LE), deep vein thrombosis/pulmonary embolism (DVT/PE), back pain, irregular menses (IM), musculoskeletal pain, pseudotumor cerebri (PTC), psychological impairment (PI), stress urinary incontinence (SUI), abdominal hernia, panniculitis, cholelithiasis, psychological diagnosis, fibromyalgia, impaired functional status (IFS), and depression. C also had the highest unemployment rates. AA had the highest angina, asthma, chronic heart failure (CHF), gout, and hypertension. H was highest substance use. A had highest diabetes, dyslipidemia, liver disease, PCOS, and tobacco/alcohol use. Conclusions: Surgical patients with obesity vary clinically by race. This provides all surgeons and physicians who manage medically complex patients with morbid obesity with advanced knowledge, supplemental to clinical judgement, that may facilitate risk-specific pre-operative preparation and peri-operative management.