Characterizing Bariatric Surgery Utilization and Complication Rates in the Adolescent Population

Mohammod Arafat, Abdullah Norain, Sathyaprasad Burjonrappa

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalJournal of Pediatric Surgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Bariatric Surgery
Comorbidity
Reoperation
Length of Stay
Morbid Obesity
Quality Improvement
Population
Surgical Wound Infection
Gastrectomy
Hispanic Americans
African Americans
Dyspnea
Type 2 Diabetes Mellitus
Weight Loss
Stomach
Demography
Databases
Hypertension
Therapeutics
Infection

Keywords

  • Adolescence
  • Bariatric surgery
  • Laparoscopic sleeve gastrectomy
  • Morbid obesity
  • Roux-En-Y gastric bypass

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Characterizing Bariatric Surgery Utilization and Complication Rates in the Adolescent Population. / Arafat, Mohammod; Norain, Abdullah; Burjonrappa, Sathyaprasad.

In: Journal of Pediatric Surgery, 01.01.2018.

Research output: Contribution to journalArticle

@article{0e166c588b674a6a992058729bcf4fc8,
title = "Characterizing Bariatric Surgery Utilization and Complication Rates in the Adolescent Population",
abstract = "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.",
keywords = "Adolescence, Bariatric surgery, Laparoscopic sleeve gastrectomy, Morbid obesity, Roux-En-Y gastric bypass",
author = "Mohammod Arafat and Abdullah Norain and Sathyaprasad Burjonrappa",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jpedsurg.2018.10.089",
language = "English (US)",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Characterizing Bariatric Surgery Utilization and Complication Rates in the Adolescent Population

AU - Arafat, Mohammod

AU - Norain, Abdullah

AU - Burjonrappa, Sathyaprasad

PY - 2018/1/1

Y1 - 2018/1/1

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

UR - http://www.scopus.com/inward/record.url?scp=85057816236&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057816236&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2018.10.089

DO - 10.1016/j.jpedsurg.2018.10.089

M3 - Article

C2 - 30522799

AN - SCOPUS:85057816236

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

ER -