TY - JOUR
T1 - Characterizing Bariatric Surgery Utilization and Complication Rates in the Adolescent Population
AU - Arafat, Mohammod
AU - Norain, Abdullah
AU - Burjonrappa, Sathyaprasad
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/2
Y1 - 2019/2
N2 - Introduction: Bariatric surgery is an increasingly common treatment of morbid obesity in the United States and has demonstrated effective weight loss and improvement of comorbidities. We used the National Surgical Quality Improvement Program (NSQIP) data to characterize bariatric surgery utilization and complication rates in the adolescent population. Methods: Demographics, surgical procedures, comorbidities, and 30-day outcomes of 2625 adolescents ages 18–21 who underwent bariatric surgery were analyzed from NSQIP data-bank from 2005 to 2015. Results: 79.5% of patients were females. Majority of patients identified as Caucasian or Black/African American (BAA) at 66.7% (73% of US population) and 15.5% (12.6% of US population), respectively. 15.9% identified as Hispanic. Comorbidities included diabetes in 9.3% (7.8% NIDDM), hypertension (9.5%), and dyspnea on moderate exertion (13.2%). Sleeve Gastrectomy, Laparoscopic Roux-En-Y (RY) and Adjustable Gastric Banding (AGB) were the three most common procedures performed during the study period. There has been a sharp trend towards SG in recent years (11.4% in 2010, to 66.6% in 2015), while RY utilization declined (47.4% in 2010 to 28.6% in 2015). Surgical complications were 2.4%, with the most common being superficial surgical site infection (0.7%), UTI (0.7%), and organ-space infection (0.4%). Reoperation and readmission rates within 30-days post-operation were 1.5% and 4.1%, respectively. Those with complications had longer length-of-stays (2.7 vs. 1.8 days, P < 0.001), greater reoperation rates (OR = 9.6, P < 0.001) and readmission rates (OR = 11.8, P < 0.001). Conclusion: Morbid obesity is associated with significant comorbidity. SG is increasingly the most utilized form of bariatric surgery. While complications are low, they are associated with greater hospital length-of-stay, readmission, and reoperation rates. Level of Evidence: Treatment Study, Level III.
AB - Introduction: Bariatric surgery is an increasingly common treatment of morbid obesity in the United States and has demonstrated effective weight loss and improvement of comorbidities. We used the National Surgical Quality Improvement Program (NSQIP) data to characterize bariatric surgery utilization and complication rates in the adolescent population. Methods: Demographics, surgical procedures, comorbidities, and 30-day outcomes of 2625 adolescents ages 18–21 who underwent bariatric surgery were analyzed from NSQIP data-bank from 2005 to 2015. Results: 79.5% of patients were females. Majority of patients identified as Caucasian or Black/African American (BAA) at 66.7% (73% of US population) and 15.5% (12.6% of US population), respectively. 15.9% identified as Hispanic. Comorbidities included diabetes in 9.3% (7.8% NIDDM), hypertension (9.5%), and dyspnea on moderate exertion (13.2%). Sleeve Gastrectomy, Laparoscopic Roux-En-Y (RY) and Adjustable Gastric Banding (AGB) were the three most common procedures performed during the study period. There has been a sharp trend towards SG in recent years (11.4% in 2010, to 66.6% in 2015), while RY utilization declined (47.4% in 2010 to 28.6% in 2015). Surgical complications were 2.4%, with the most common being superficial surgical site infection (0.7%), UTI (0.7%), and organ-space infection (0.4%). Reoperation and readmission rates within 30-days post-operation were 1.5% and 4.1%, respectively. Those with complications had longer length-of-stays (2.7 vs. 1.8 days, P < 0.001), greater reoperation rates (OR = 9.6, P < 0.001) and readmission rates (OR = 11.8, P < 0.001). Conclusion: Morbid obesity is associated with significant comorbidity. SG is increasingly the most utilized form of bariatric surgery. While complications are low, they are associated with greater hospital length-of-stay, readmission, and reoperation rates. Level of Evidence: Treatment Study, Level III.
KW - Adolescence
KW - Bariatric surgery
KW - Laparoscopic sleeve gastrectomy
KW - Morbid obesity
KW - Roux-En-Y gastric bypass
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U2 - 10.1016/j.jpedsurg.2018.10.089
DO - 10.1016/j.jpedsurg.2018.10.089
M3 - Article
C2 - 30522799
AN - SCOPUS:85057816236
SN - 0022-3468
VL - 54
SP - 288
EP - 292
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 2
ER -