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Published in: Surgical Endoscopy 8/2020

01-08-2020 | Obesity | 2019 SAGES Oral

Male gender is an independent risk factor for patients undergoing laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass: an MBSAQIP® database analysis

Authors: Nicholas Dugan, Kyle J. Thompson, Selwan Barbat, Tanushree Prasad, Iain H. McKillop, Sean R. Maloney, Amanda Roberts, Keith S. Gersin, Timothy S. Kuwada, Abdelrahman Nimeri

Published in: Surgical Endoscopy | Issue 8/2020

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Abstract

Background

Male patients undergoing bariatric surgery have (historically) been considered higher risk than females. The aim of this study was to examine the disparity between genders undergoing laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB) procedures and assess gender as an independent risk factor.

Methods

The MBSAQIP® Data Registry Participant User Files for 2015–2017 was reviewed for patients having primary SG and RYGB. Patients were divided into groups based on gender and procedure. Variables for major complications were grouped together, including but not limited to PE, stroke, and MI. Univariate and propensity matching analyses were performed.

Results

Of 429,664 cases, 20.58% were male. Univariate analysis demonstrated males were older (46.48 ± 11.96 vs. 43.71 ± 11.89 years, p < 0.0001), had higher BMI (46.58 ± 8.46 vs. 45.05 ± 7.75 kg/m2, p < 0.0001), and had higher incidence of comorbidities. Males had higher rates of major complications (1.72 vs. 1.05%; p < 0.0001) and 30-day mortality (0.18 vs. 0.07%, p < 0.0001). Significance was maintained after subgroup analysis of SG and RYGB. Propensity matched analysis demonstrated male gender was an independent risk factor for RYGB and SG, major complications [2.21 vs. 1.7%, p < 0.0001 (RYGB), 1.12 vs. 0.89%, p < 0.0001 (SG)], and mortality [0.23 vs. 0.12%, p < 0.0001 (RYGB), 0.10 vs. 0.05%; p < 0.0001 (SG)].

Conclusion

Males continue to represent a disproportionately small percentage of bariatric surgery patients despite having no difference in obesity rates compared to females. Male gender is an independent risk factor for major post-operative complications and 30-day mortality, even after controlling for comorbidities.
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Metadata
Title
Male gender is an independent risk factor for patients undergoing laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass: an MBSAQIP® database analysis
Authors
Nicholas Dugan
Kyle J. Thompson
Selwan Barbat
Tanushree Prasad
Iain H. McKillop
Sean R. Maloney
Amanda Roberts
Keith S. Gersin
Timothy S. Kuwada
Abdelrahman Nimeri
Publication date
01-08-2020
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 8/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-07106-0

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