Original articleHealth Disparities in Adolescent Bariatric Surgery: Nationwide Outcomes and Utilization
Section snippets
Participants and materials
Adolescents with age ≥12 to <19 years who underwent bariatric surgery were identified using the Bariatric Outcomes Longitudinal Database (BOLD), years 2007–2014. The BOLD, created by the Surgical Review Corporation, is a repository from the American Society for Metabolic and Bariatric Surgery–Bariatric Surgery Center of Excellence (BSCOE) participants [17]. BSCOE participants (563 centers, during the study period, distributed across the nation) entered prospective data for bariatric surgery
Baseline characteristics
We identified 1,539 adolescents who underwent bariatric surgery. Table 1 shows demographic characteristics, preoperative BMI, rates of ORCs, and the proportion of each type of bariatric procedure. Our sample demonstrated a greater proportion of females (76%; n = 1,176) and whites (63%; n = 962) undergoing bariatric surgery. The average age at surgery was 16.9 ± 2.6 years and the average preoperative BMI was 48.2 ± 9.4 kg/m2. The most common ORC was hypertension (57%; n = 821). Gastric bypass
Discussion
Our study explored the outcomes and utilization of adolescent bariatric surgery using a national comprehensive repository. The characteristics of our study population resemble those previously reported, in which female patients account for 75%–80% and whites represent 65%–79% of the adolescents who undergo bariatric surgery [18], [19].
There are baseline differences in demographics and ORCs observed across our study population both in sex and race stratification. For example, males have higher
Acknowledgments
The authors would like to thank the Surgical Review Corporation and the American Society for Metabolic and Bariatric Surgery–Bariatric Surgery Center of Excellence participants. A poster version of this work was presented at the 2016 Annual Clinical Congress of the American College of Surgeons.
References (40)
- et al.
Characterizing extreme values of body mass index – for-age by using the 2000 Centers for Disease Control and Prevention growth charts
Am J Clin Nutr
(2009) Bariatric surgery in Youth
Endocrinol Metab Clin North Am
(2016)- et al.
Cardiovascular Risk Factors and Excess Adiposity Among Overweight Children and Adolescents: The Bogalusa Heart Study
J Pediatr
(2007) - et al.
American Society for Metabolic and Bariatric Surgery. ASMBS pediatric committee best practice guidelines
Surg Obes Relat Dis
(2012) - et al.
Baseline data from American society for metabolic and bariatric surgery-designated bariatric surgery centers of excellence using the Bariatric Outcomes Longitudinal Database
Surg Obes Relat Dis
(2010) - et al.
Socioeconomic disparities in eligibility and access to bariatric surgery: A national population-based analysis
Surg Obes Relat Dis
(2010) - et al.
Plateaued national utilization of adolescent bariatric surgery despite increasing prevalence of obesity-associated co-morbidities
Surg Obes Relat Dis
(2016) - et al.
Changes in weight and co-morbidities among adolescents undergoing bariatric surgery: 1-year results from the Bariatric Outcomes Longitudinal Database
Surg Obes Relat Dis
(2013) - et al.
Laparoscopic sleeve gastrectomy leads the U.S. utilization of bariatric surgery at academic medical centers
Surg Obes Relat Dis
(2015) - et al.
One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: A multicenter study from the pediatric bariatric study group
J Pediatr Surg
(2006)
Prevalence of obesity and severe obesity in US children, 1999-2014
Obesity
Expert committee recommendations regarding the prevention, assessment, and treatment of Child and adolescent overweight and Obesity: Summary report
Pediatrics
Cardiovascular Risk Factors in Severely Obese Adolescents: The Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study
JAMA Pediatr
Obesity in the Transition to adulthood
Arch Pediatr Adolesc Med
Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: Systematic review
Int J Obes (Lond)
Bariatric surgery for severely overweight adolescents: Concerns and recommendations
Pediatrics
Is adolescent gastric-restrictive antiobesity surgery warranted?
Obes Surg Incl Laparosc Allied Care
Adolescent bariatric Surgery: Treatment delayed may Be treatment denied
Pediatrics
Bariatric surgery in adolescents recent national trends in use and in-hospital outcome
Arch Pediatr Adolesc Med
Recent national trends in the use of adolescent inpatient bariatric surgery: 2000 through 2009
JAMA Pediatr
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2022, Journal of Surgical ResearchCitation Excerpt :Similarly, reports of the Kids’ Inpatient Database and the Bariatric Outcomes Longitudinal Database found that the majority (60% and 63%, respectively) of adolescents undergoing bariatric surgery were white.24,29 In addition, the median body mass index in our population was higher at 54.4 kg/m2, compared to 50.5 kg/m2 in Teen-LABS, 47.3 kg/m2 in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, and 48.2 kg/m2 in the Bariatric Outcomes Longitudinal Database database.24,26,30 Although the uniqueness of our cohort affects the generalizability of our findings, our study may be more representative of the patient population in the Southern United States, where the obesity epidemic is most prominent.
Racial disparities in bariatric surgery postoperative weight loss and patient satisfaction
2022, American Journal of SurgeryCitation Excerpt :Moreover, studies have shown that even after undergoing bariatric surgery, African American patients may experience significantly less weight loss compared to Caucasian patients.4–19 Studies examining Hispanic patients have generally shown no difference in weight loss outcomes when compared to other races, although there are relatively fewer studies which include Hispanic patients, thus limiting their conclusions.4,5,7,8,10,20–27 While a fair number of studies have been published examining racial disparities in postoperative weight loss, many of these studies are limited by study design, patient population or strength of statistical analysis as highlighted in a recent review by Zhao et al.28 The authors noted the limited data available on Hispanic patients with 20 of 53 studies examined including Hispanic patients, despite them being a relatively large portion of the minority population in the United States.28
Racial disparities in bariatric surgery postoperative weight loss and co-morbidity resolution: a systematic review
2021, Surgery for Obesity and Related DiseasesCitation Excerpt :Five studies compared remission of HLD between NHW and NHB patients after surgery [11,22,34,47,53], all of which found no significant difference in the rates of resolution. There are 4 studies that included other races and had similar findings [10,15,18,38]. Of the 3 studies that compared the resolution of OSA between NHW and NHB patients, Wood et al. [11] found that black patients had significantly higher rates of remission compared to white patients (62.6% versus 56.1% for OSA).
Conflicts of Interest: The authors have no conflicts of interest to disclose.