Recent trends of bariatric surgery in adolescent population in the state of New York

Abstract

BackgroundIn the United States the percentage of adolescents with obesity has reached an alarming level of 21%. Bariatric surgery has emerged as a successful intervention in the weight loss for adolescents. ObjectiveTo compare bariatric procedures performed in adolescent and adult populations. SettingUniversity Hospital, United States. MethodsUsing the Statewide Planning and Research Cooperative System (SPARCS) database, records from the adolescent (age 12-21years) and adult populations undergoing bariatric surgery during 2005-2014 were examined. Patients’ demographics, surgery type (Roux-en-Y gastric bypass (RYGB), Sleeve Gastrectomy (SG), Laparoscopic Adjustable Gastric Banding (LAGB), length of stay (LOS), complications and comorbidities were analyzed. ResultsThe annual adolescent bariatric cases increased from 150 in 2005 to 406 in 2014. In the adolescent population, increasing utilization trends were noted in the Hispanic population (RR=1.08, p-value<0.0001), use of Public (Medicaid or Medicare) insurance (RR=1.10, p-value=0.0003) and SG procedures (RR= 1.56, p-value <0.0001). Decreasing trends were noted in the Caucasian population (RR=0.95, p-value<0.0001), RYGB (RR=0.92, p-value<0.0001) and LAGB (RR= 0.84, p-value=0.0001). Adolescents undergoing bariatric surgery had fewer comorbidities (55.4% vs 81.1%, p-value<0.0001), experienced fewer complications (3.3% vs 4.9%, p-value<0.0001) and 30-day readmissions (3.8% vs 5.0%, p-value=0.0029). Length of stay was also found to be significantly shorter for the adolescent population (1.73 vs 2.00 days, p-value<0.0001). After adjusting for other confounding factors, adolescent patients still had significantly lower complication risk (p-value=0.01) and shorter length of stay (p-value=0.0005) than adults. ConclusionBariatric surgery procedure rates have increased in the adolescent population with increasing trend of using LSG. The data from our study supports that bariatric surgery is safe in adolescents with significantly lower complication risk and shorter length of stay as compared to the adult population.