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Adolescent Bariatric Surgery: Racial Disparities in 30-Day Outcomes Using the MBSAQIP from 2015 to 2018

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Abstract

Introduction

Racial disparities exist in obesity prevalence and obesity-related comorbid conditions among youth. We hypothesized that non-White adolescents would have poorer 30-day outcomes after adolescent bariatric surgery.

Methods

Adolescent patients 19 years or younger who had bariatric surgery from January 2015 to December 2018 were identified in the Metabolic and Bariatric Surgery Accreditation and Quality Initiative Program datafiles. Patient characteristics and 30-day perioperative outcomes were compared across racial groups. Trends in utilization of adolescent bariatric surgery were evaluated by race and procedure.

Results

Bariatric surgery was performed in 3177 adolescents with a mean age of 17.9 years [standard deviation (SD) 1.1 years]. The majority of patients were White 71.5% (2,271), while only 16.4% (520) were Black, and 12.1% (386) were other. Black adolescents 42.7% (222) more commonly presented with a BMI >50kg/m2 compared to 28.4% (645) White and 27.2% (105) other. Baseline hypertension and sleep apnea were more common among Black adolescents than other racial groups (P< 0.05). Black adolescents with LRYGB comprised 4.6% (48) of procedures in 2015 and only 1.5% (11) in 2018. Clavien-Dindo complications and all-cause readmission rates were similar among racial groups. Mean BMI decrease after 30 days was greatest for Black patients after Roux-en-Y gastric bypass, with a loss of 3.1 BMI points (SD 1.5).

Conclusions

Despite similar short-term outcomes, significant disparities exist for Black adolescents who qualify for bariatric surgery. Further investigation is warranted to better understand the racial differences that limit access and utilization of this safe and effective intervention.

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Funding

The Duke Biostatistics, Epidemiology, and Research Design Core’s support was made possible by the CTSA grant (UL1TR002553) from the National Center for Advancing Translational Sciences (NCATS) of the NIH and the NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not represent the official views of NCATS or NIH.

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All authors have contributed equally to this work.

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Correspondence to Keri A. Seymour.

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This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study, formal consent is not required.

Conflict of Interest

Maragatha Kuchibhatla was a consultant to Aniara Diagnostica. The other authors have no conflicts of interest to declare.

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Key Points

• Racial disparities exist in adolescents who underwent bariatric surgery.

• Black adolescents only made up 16.4% of the total cohort between 2015 and 2018.

• Black adolescents present with higher BMI and greater rates of hypertension, OSA.

• Black adolescents had comparable 30-day outcomes compared to White adolescents.

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Steinberger, A.E., Youngwirth, L.M., Kim, S.E. et al. Adolescent Bariatric Surgery: Racial Disparities in 30-Day Outcomes Using the MBSAQIP from 2015 to 2018. OBES SURG 31, 3776–3785 (2021). https://doi.org/10.1007/s11695-021-05500-z

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