SOCIODEMOGRAPHIC FACTORS ASSOCIATED WITH UNDERGOING BARIATRIC SURGERY AMONG INFORMATION SESSION ATTENDEES
Gerard D. Hoeltzel*, David Sigmon, Kristoffel Dumon, Noel N. Williams, Colleen Tewksbury, Octavia Pickett-Blakely
Department of Surgery, University of Pennsylvania, Philadelphia, PA
INTRODUCTION
Despite the growing prevalence of obesity in the U.S., less than 1% of eligible patients undergo bariatric surgery. Prior studies have described demographic and clinical characteristics of the bariatric surgery population (at the time of surgery), however, few studies examine the factors that are associated with proceeding from an interest in bariatric surgery (e.g. attending an information session) to having the operation. This study examined characteristics of patients who expressed an interest in bariatric surgery and either did or did not undergo surgery to
to determine factors differentiating these two populations.
METHODS
This retrospective, cross-sectional study examined a population of patients who attended bariatric surgery information sessions conducted at an academic medical center. Utilizing the electronic medical record, sociodemographic (age, sex, race, median income based on zip code and mileage distance from hospital) and clinical (baseline BMI and comorbidity) data was collected for bariatric surgery information session attendees from January 2014 to April 2016. Each attendee's chart was reviewed to determine if they indeed underwent bariatric surgery (either a Roux-en-Y gastric bypass or sleeve gastrectomy). Descriptive statistics were gathered and a multivariate logistic regression was performed to determine variables associated with undergoing bariatric surgery.
RESULTS
Over a two- year period 1,528 patients attended a bariatric surgery information session. A total of 249 (16.3%) of eligible attendees underwent bariatric surgery. When comparing those who did and did not undergo surgery, significant differences were observed in age, sex and BMI class. Younger attendees were more likely to undergo surgery (OR 0.98, CI: 0.98, 0.99).
Females had increased odds of having surgery (OR 1.47, CI: 1.02,2.11). Compared with BMI 35- 39.99 kg/m2, those with higher BMI had increased odds of having surgery (BMI of 40-45 [OR 1.77], 45-50 [OR 1.66], and ≥50 kg/m2[ [OR 1.89]] Median income, race, distance from the hospital, and medical comorbidity (measured by Charlson Comorbidity Index) were not associated with undergoing bariatric surgery after attending a bariatric surgery information session.
CONCLUSION
The results from this study are consistent with prior data showing that young age, female sex, and higher BMI classes are associated with patients undergoing bariatric surgery. Although we show that only a small proportion (16.3%) of those who attend a bariatric surgery information session underwent an operation, this proportion is greater than the 1% of eligible individuals nationwide. Future studies should focus on understanding factors that influence the decision-making process in an effort to drive resource allocation that ensures as many eligible patients as possible receive this effective treatment for obesity.
Table 1. Univariate Analysis and Multivariate Logistic Regression for Predicting Bariatric Surgery
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