Predictors of Preoperative Program Non-Completion in Adolescents Referred for Bariatric Surgery

  • Cassie Brode
  • Megan Ratcliff
  • Jennifer Reiter-Purtill
  • Sanita Hunsaker
  • Michael Helmrath
  • Meg Zeller
Original Contributions

Abstract

Background

Factors contributing to adolescents’ non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery.

Objectives

The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery (“completers”) or withdrew from treatment (“non-completers”).

Setting

Adolescents were from a bariatric surgery program within a pediatric tertiary care hospital.

Methods

A retrospective chart review was conducted of consecutive patients who completed bariatric surgery psychological intake evaluations from September 2009 to April 2013. Data involving completer (n = 61) versus non-completer (n = 65) status were analyzed using two-tailed independent t tests, Chi-squared tests, and logistic regressions.

Results

Forty-three percent of adolescents completed surgery, similar to adult bariatric samples. Significantly more males were non-completers (p < .05), and there was a trend towards non-completion for older adolescents (p = 0.06). No other demographic, psychological, or caregiver/family variables were significant predictors of non-completion.

Conclusions

These findings indicate that demographic variables, rather than psychological or family factors, were associated with the progression to or withdrawal from surgery. Further assessment is needed to determine specific reasons for completing or withdrawing from treatment, particularly for males and older adolescents, to improve clinical care and reduce attrition.

Keywords

Adolescent bariatric surgery Predictors of surgery non-completion Caregiver weight loss surgery Attrition 

Notes

Acknowledgments

We acknowledge Linda Kollar, RN, MSN, CBN, Cassandra McDaniel, BA, Kathy Hrovat, MS, RD, LD, and Taylor Howarth, BA, for their contributions to this work.

Compliance with Ethical Standards

The current study received Institutional Review Board approval.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Formal consent is not required for data collection as part of routine clinical practice.

Statement of Human and Animal Rights

This study received institutional review board approval. All procedures performed were in accordance with institutional and national ethical standards of studies involving human participants.

Funding Agency

The first author was supported by a training grant from the National Institutes of Health (T32DK063929).

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Behavioral Medicine and PsychiatryWest Virginia University School of MedicineMorgantownUSA
  2. 2.AtlantaUSA
  3. 3.Division of Behavioral Medicine and Clinical PsychologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  4. 4.Department of Pediatric SurgeryCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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