Hospital Length of Stay after Metabolic and Bariatric Surgery by Race/Ethnicity and Procedure Type among Florida Patients

Abstract

ObjectivesMetabolic and Bariatric Surgery (MBS) has become increasingly common as a treatment option for severely obese. We examined the association of hospital length of stay (LOS) by race-ethnicity (Hispanic, non-Hispanic white [NHW], NH black [NHB]) and MBS-procedure among Florida inpatients. DesignSecondary analysis of inpatient records was performed using the 2016 Florida Agency for Health Care Administrative (AHCA) data. Records of Laparoscopic Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Adjustable Gastric Banding (LAGB), and Sleeve Gastrectomy (SG) procedures based on ICD 10th edition code were analyzed. Via logistic regression analysis, the adjusted odds ratio (aOR) of longer LOS (≥2 versus < 2days) and the corresponding 95% confidence interval (CI) were calculated for racial-ethnic groups (NHW versus other groups) and MBS type (SG versus LAGB or RYGB) adjusted for age, sex, BMI, and insurance status. ResultsThe majority of the sample (N = 10,630, approximately 56% NHW, 21% NHB, 20% Hispanic, 3% Other) underwent SG (71%), followed by RYGB (24%) and LAGB (5%). Hispanic were more likely (aOR 1.27; 95% CI 1.14–1.42) and NHB were less likely (0.68; 0.61–0.75) than NHW to have longer LOS regardless of MBS type. Compared to SG, LAGB patients were more likely (2.09; 1.70–2.55) but RYGB patients were less likely (0.32; 0.29–0.36) to have longer LOS. ConclusionsAlthough LAGB is considered the least invasive MBS, recipients tend to stay longer in hospital after adjustment for health insurance and sociodemographic factors. Medical and socioecological reasons for racial-ethnic variations in LOS relating MBS should be explored further.