Bariatric surgery in adolescents: Recent national trends in use and in-hospital outcome

Objectives: To analyze recent nationwide trends in the use of adolescent bariatric surgery and to compare early postoperative outcomes of adolescents and adults undergoing these procedures. Design: Analysis of national administrative data by using survey analysis techniques. Setting: Data obtained from the Nationwide Inpatient Sample from 1996 to 2003. Participants: Adolescents (aged <20 years) and adults undergoing bariatric surgery. Intervention: Bariatric surgery. Main Outcome Measures: Population-based case rates, major postoperative complications, length of hospital stay, hospital charges, and mortality. Results: The population-based annual adolescent bariatric case volume varied little between 1996 and 2000 but more than tripled from 2000 to 2003. Despite this trend, only 771 bariatric procedures were performed in adolescents in 2003, representing fewer than 0.7% of bariatric procedures performed nationwide. Univariate comparison with data from 2003 showed a similar in-hospital complication rate in adolescents and adults but a significantly shorter length of stay among adolescents. Although in-hospital mortality was observed in 0.2% of adults, no in-hospital deaths were observed in any adolescents. Conclusions: Although procedure rates have increased recently, bariatric surgery in adolescents remains an uncommonly performed procedure. These data support efforts to align bariatric surgery programs for adolescents initially with higher volume programs for adults and to develop multicenter collaborative studies directed at defining the short- and long-term effect of bariatric surgery in morbidly obese adolescents.