Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
Center for Patient Safety and Quality Research, Boston Children's Hospital, Boston, Massachusetts.
J Adolesc Health. 2017 Sep;61(3):310-316. doi: 10.1016/j.jadohealth.2017.03.020. Epub 2017 Jun 3.
Data from low-weight patients with restrictive eating disorders (EDs) treated in outpatient adolescent medicine-based ED treatment programs were analyzed to determine whether there was an association between hospitalization and gain to at least 90% median body mass index (mBMI) at 1-year follow-up.
Data were retrospectively collected for 322 low-weight (<85% mBMI at intake) patients aged 9-21 years, who presented with restrictive EDs to 14 adolescent medicine-based ED programs in 2010. Positive outcome was defined as being at least 90% mBMI (%mBMI = patient's body mass index/mBMI for age × 100) at 1-year follow-up. Association between treatment at a higher level of care and gain to at least 90% mBMI was analyzed for 140 patients who were <85% mBMI at the time of presentation, had not been previously hospitalized, and had 1-year follow-up data available.
For patients presenting at <85% mBMI, those who were hospitalized in the year following intake had 4.0 (95% confidence interval: 1.6-10.1) times the odds of gain to at least 90% mBMI, compared with patients who were not hospitalized, when controlling for baseline %mBMI.
In this national cohort of patients with restrictive EDs presenting to adolescent medicine-based ED programs at <85% mBMI, those who were hospitalized had greater odds of being at least 90% mBMI at 1-year follow-up.
对在以青少年医学为基础的 ED 治疗项目中接受门诊治疗的体重较轻(摄入时 ED 体重指数[BMI]低于 85%)、存在限制型 ED 的患者数据进行分析,以确定住院治疗与在 1 年随访时 BMI 至少增加至 90%中位数(mBMI)之间是否存在关联。
对 2010 年来自 14 个以青少年医学为基础的 ED 项目、年龄为 9-21 岁、存在限制型 ED 的 322 名低体重(摄入时 ED BMI 低于 85% mBMI)患者的数据进行回顾性收集。积极的结果定义为在 1 年随访时 BMI 至少增加至 90% mBMI(%mBMI=患者 BMI/mBMI 年龄×100)。对 140 名摄入时 ED BMI 低于 85%、之前未住院且有 1 年随访数据的患者,分析接受更高水平治疗与 BMI 至少增加至 90% mBMI 之间的关联。
对于摄入时 ED BMI 低于 85%的患者,与未住院的患者相比,在摄入后 1 年内住院的患者 BMI 至少增加至 90% mBMI 的几率是其 4.0 倍(95%置信区间:1.6-10.1),控制基线%mBMI 后。
在这个摄入时 ED BMI 低于 85%、到以青少年医学为基础的 ED 治疗项目就诊的限制型 ED 患者的全国性队列中,与未住院的患者相比,住院患者在 1 年随访时 BMI 至少增加至 90% mBMI 的几率更高。