Background

While the safety of adolescent metabolic bariatric surgery (MBS) has been demonstrated, there is limited data surrounding the role of socioeconomic factors. This study subsequently aims to examine how socioeconomic status affects short and long-term outcomes of adolescent MBS.

Methods

Patients aged 12-19 who underwent MBS between 2007-2018 were identified using the New York Statewide Planning and Research Cooperative System database. For each patient, 30-day readmissions, length of stay (LOS), in-hospital complications, and need for revision or conversion (RC) was identified. Socioeconomic status was measured using area deprivation index (ADI) scores. ADI scores were stratified into three groups: low (1-4), median (5-7), and high (8-10), with lower scores indicating higher SES. Multivariate regression models were used for analysis.

Results

2,241 adolescents underwent MBS in the study time frame. Adolescents with low and median ADI scores were more likely to undergo SG than patients with high scores (58.53% and 65.65% vs. 37.72% respectively, p<0.0001).Patients with lower and median ADI scores were less likely to have a subsequent RC after bariatric procedure than patients with a high ADI score (low vs. high: OR=0.484, 95% CI 0.263- 0.889; median vs. high: OR=0.536, 95% CI 0.288- 0.996).30-day readmissions, complications, or LOS did not differ significantly across ADI levels.

Conclusions

ADI level is associated with both procedure choice and long-term outcomes, with disadvantaged adolescents more likely to undergo RYGB and subsequent RC.