Racial disparities in inferior vena cava filter use in metabolic and bariatric surgery patients: Nationwide insights from the MBSAQIP database - 12/04/21
, Michael Mazzei b , Huaqing Zhao c , Satyajit Reddy d , Riyaz Bashir e Abstract |
Background |
Prophylactic inferior vena cava (IVC) filter use in bariatric surgery patients is a physician- and patient-dependent practice pattern with unclear safety and efficacy. Factors that mediate physicians’ decisions for IVC filter placement preoperatively remain unclear. The role of race in decision-making also remains unclear.
Methods |
From the 2015–2016 MBASQIP database, patient characteristics leading to IVC filter use and outcomes after IVC filter placement were compared between Black and White primary bariatric surgery patients.
Results |
Prophylactic IVC filter was used in 0.66% of Black and White patients. IVC filter use was three-fold higher in Black patients, despite this cohort having a lower venous thromboembolism (VTE) risk profile than White counterparts. Black race was an independent predictor for IVC filter placement on multivariate analysis. After receiving an IVC filter, Black patients had higher rates of 30-day adverse outcomes.
Conclusions |
In this study, Black race was independently associated with the likelihood of receiving a prophylactic IVC filter, despite lower rates of VTE risk factors and lack of recommendations for its use. Further research is needed to explore why this disparity in clinical practice exists.
Le texte complet de cet article est disponible en PDF.Highlights |
• | VTE following metabolic and bariatric remain an uncommon complication. |
• | VTE is the most common cause of bariatric-related mortality. |
• | IVC filter use is not routine recommended in MBS patients. |
• | IVC filter use is associated with more adverse outcomes than benefit. |
• | IVC filter was used disproportionately in Black patients. |
• | Reasons for this disparity in clinical practice remains unclear. |
Keywords : Bariatric surgery, IVC filter use, Disparity in practice pattern
Plan
Vol 221 - N° 4
P. 749-758 - avril 2021 Retour au numéro
Article précédent
- Exploring racial disparity in perioperative outcomes following revisional bariatric surgery: A case-control matched analysis
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