Introducing a Bariatric Surgery Program at a Large Urban Safety Net Medical Center Serving a Primarily Hispanic Patient Population

• Published in: Obesity surgery Vol. 31; no. 9; pp. 4093 - 4099
• Main Authors: James, Tayler J., Sener, Stephen F., Nguyen, James D., Rothschild, Marc, Hawley, Lauren, Patel, Tanu A., Sargent, Rachel, Dobrowolsky, Adrian
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-09-2021; Springer Nature B.V
• Subjects: Bariatric Surgery; Comorbidity; Diabetes; Gastrectomy; Gastric Bypass; Gastrointestinal surgery; Hispanic or Latino; Humans; Laparoscopy; Medicine; Medicine & Public Health; Obesity, Morbid - surgery; Original Contributions; Patients; Postoperative Complications; Retrospective Studies; Socioeconomic factors; Surgery; Treatment Outcome; Weight Loss; Disparities; Hispanic; Bariatric surgery; Safety net hospital; Sleeve gastrectomy
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-021-05539-y

Background
Few bariatric surgery programs exist at safety net hospitals which often serve patients of diverse racial and socioeconomic backgrounds. A bariatric surgery program was developed at a large urban safety net medical center serving a primarily Hispanic population. The purpose of this study was to evaluate safety, feasibility, and first-year outcomes to pave the way for other safety net bariatric programs.
Methods
The bariatric surgery program was started at a safety net hospital located in a neighborhood with over twice the national poverty rate. A retrospective review was performed for patient demographics, comorbidities, preoperative diet and exercise habits, perioperative outcomes, and 1-year outcomes including percent total weight lost (%TWL) and comorbidity reduction.
Results
A total of 153 patients underwent laparoscopic sleeve gastrectomy from May 2017 through December 2019. The average preoperative BMI was 47.9kg/m
2
, and 54% of patients had diabetes. The 1-year follow-up rate was 94%. There were no mortalities and low complication rates. The average 1-year %TWL was 22.8%. Hypertension and diabetes medications decreased in 52% and 55% of patients, respectively. The proportion of diabetic patients with postoperative HbA1c
<
6.0% was 49%.
Conclusion
This is one of the first reports on the outcomes of a bariatric surgery program at a safety net hospital. This analysis demonstrates feasibility and safety, with no mortalities, low complication rates, and acceptable %TWL and comorbidity improvement. More work is needed to investigate the impacts of race, culture, and socioeconomic factors on bariatric outcomes in this population.
Graphical abstract