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Visit Adherence in the First Two Years Following Adolescent Bariatric Surgery


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•Bariatric surgery is becoming a more common treatment in severe adolescent obesity.
•Tracking safety and efficacy outcomes is an important component of bariatric surgery programs.
•Studies demonstrate high attrition rates in weight management programs, especially among adolescents with severe obesity
•Few studies describe attrition rates in adolescent bariatric programs.


•To describe attrition among post-operative adolescent bariatric patients. 
•To investigate if patient demographics or surgical procedure type impact attrition              

Design: Retrospective cohort study using data from a prospective bariatric surgery registry for patients enrolled in Nemours Bariatric Surgery Program.

Inclusion Criteria: ≥ 14 years of age, BMI ≥ 40; Patients who completed a pre-operative program of monthly visits for minimum of 6 months with interdisciplinary team and have undergone bariatric surgery

Outcome Measures:

•Visit attendance defined by presence at in-person post-operative clinic visit at 8 time points.
•Program attrition for one year and two years post-op was defined as no visit at month nine and beyond, or month 18 and beyond.

Analyses: Attrition rates were described for the entire cohort and then for subgroups based on demographics and type of surgery (Gastric Band performed between 2007 and 2012 or Sleeve performed after 2012). Groups were compared using chi-square analysis.


•Post-operative visit attendance for adolescents undergoing bariatric surgery decreases after the 6 month time point, with over 1 in 3 patients falling into the program attrition category at 2 years independent of demographic make-up and surgical procedure.
•Further investigation of the etiology of this finding, as well as the risks associated with program attrition is warranted.
•Creation of novel methods to engage these adolescents may improve the safety and monitoring of adolescent bariatric surgical patients.
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