Limited English proficiency is not associated with worse outcomes after bariatric surgery.
Timothy Feeney1,2, Stephanie Vaughn2, Jacob Nudel1,2, Donald Hess1,2, Brian Carmine1,2, Cullen Carter1,2, Luise Pernar1,2, F. Thurston Drake1,2 1Boston Medical Center 2Boston University School of Medicine
Background:
Previous research has shown conflicting results regarding the impact of English language proficiency on medical and surgical outcomes. The objective of this study was to evaluate whether primary language was associated with differences in outcomes after bariatric operations.
Methods:
Retrospective cohort study of New Jersey hospitals from 2009-14 evaluating adult patients with ICD-9 diagnoses of obesity who underwent laparoscopic sleeve gastrectomy, laparoscopic Roux-en-Y gastrectomy (lap RYGB), or open RYGB. NJ was selected because these data include patients’ primary languages. Spanish speakers and non-English/non-Spanish (NENS) speakers were compared to English speakers. In-hospital mortality, 7-day readmission, and LOS were evaluated.
Results:
25,272 patients met inclusion criteria; 24,200 (96%) spoke English, 780 (3%) spoke Spanish, and 292 (1%) were NENS speakers. There were 17,090 (67.6%) sleeve gastrectomies, 7,492 (29.6%) lap RYGBs, and 690 (2.7%) open RYGBs. No difference was observed in the number of operation types among each language group. There was no difference in mortality and lower readmissions among non-English speakers, but the absolute number of deaths and 7-day readmissions was low (1[<0.1%] and 6[<0.8%] among non-English speakers, respectively). Adjusted analysis showed no change in LOS for Spanish speakers or NENS speakers versus English speakers (IRR 0.96, 95%CI [0.91-1.02] and 0.95 [0.86-1.05], respectively).
Conclusion:
In this large cohort of bariatric surgery patients, there was no association between language and short-term post-operative outcomes. These results may indicate that the highly protocolized course following bariatric surgery mitigates risks that may arise from communication difficulties
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