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

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. Graphical abstract: [Figure not available: see fulltext.]