National Trends in Pediatric Metabolic and Bariatric Surgery: 2010-2017

Area of Science:

• Pediatric Surgery
• Obesity Medicine
• Public Health

Background:

• Childhood obesity is a growing epidemic, disproportionately affecting minority populations.
• Metabolic and bariatric surgery (MBS) is a vital multidisciplinary treatment option for qualifying pediatric patients.
• National trends in pediatric MBS require examination to understand current utilization and outcomes.

Purpose of the Study:

• To analyze national trends in pediatric metabolic and bariatric surgery (MBS) between 2010 and 2017.
• To identify changes in procedure rates, types, patient demographics, and outcomes.
• To highlight potential disparities in access to pediatric weight loss surgery.

Main Methods:

• Utilized weighted discharge data from the National Inpatient Sample (NIS) for pediatric patients (<19 years old) from 2010 to 2017.
• Analyzed national procedure rates as the primary outcome.
• Examined secondary outcomes including procedure type, patient demographics, BMI, comorbidities, length of stay, and complication rates.

Main Results:

• Annual pediatric MBS rates significantly increased from 2.29 to 4.62 per 100,000 between 2010 and 2017.
• Laparoscopic sleeve gastrectomy became the predominant procedure, surpassing gastric bypass and adjustable gastric banding.
• While length of stay decreased and complication rates remained low, preoperative BMI increased, and minority access remained disproportionately low.

Conclusions:

• Pediatric metabolic and bariatric surgery (MBS) is significantly underutilized nationally.
• Significant racial and social disparities persist, limiting access to pediatric weight loss surgery for minority groups.
• Further research into social determinants is crucial to improve equitable access to MBS for adolescents.