Outcomes of Bariatric Surgery from Adolescence to Young Adulthood
Background Bariatric surgery is now accepted for adolescents; however, we may need to improve access to surgery for this vulnerable age group.
Methods All patients aged 13-25 years in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database from 2015-2018 with a CPT code for laparoscopic sleeve gastrectomy or gastric bypass were included. Patients were analyzed by age: adolescents(13-17), college-aged(18-21), and young adults(22-25). Primary outcomes were change in BMI, percent excess weight loss at 30-days, and complications.
Results 27,292 patients underwent sleeve gastrectomy: 879(3.2%) adolescents, 7955(29.2%) college-aged, and 18,447(67.6%) young adults. The proportion of females increased with age. College-aged were most likely to have hypertension, while adolescents were most likely to be diabetic and had the highest preoperative weight and BMI. 30-day change in BMI and percent excess weight loss were highest in the college-aged group(Table). Complications occurred in 36(4.1%) adolescents, 324(4.1%) college-aged, and 803(4.4%) young adults(p=0.56)(Table). Readmission was the most common complication and was most often due to nausea and vomiting. 30-day reoperation rates were <1% for each group.
8292 patients underwent gastric bypass: 146(1.8%) adolescents, 2207(26.6%) college-aged, and 5939(71.6%) young adults. Older patients were more likely to be female. Three-quarters of young adults had sleep apnea, while adolescents were most likely to be diabetic and had the highest preoperative weight and BMI. 30-day change in BMI and percent excess weight loss were highest in adolescents(Table). Complications occurred in 13(8.9%) adolescents, 198(9.0%) college-aged, and 580(9.0%) young adults(p=0.54)(Table). 30-day readmission was the most common complication and most readmissions were due to nausea and vomiting. Approximately 2% of patients in each group required reoperation.
Conclusions Providers may be reluctant to refer adolescents for bariatric surgery, reflected by higher BMI and diabetes incidence, but our data suggests that these procedures can be safely performed in children as young as 13.