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住院对限制型进食障碍的消瘦青少年一年后体重中位数百分比的影响。

Effect of Hospitalization on Percent Median Body Mass Index at One Year, in Underweight Youth With Restrictive Eating Disorders.

机构信息

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.

出版信息

J Adolesc Health. 2017 Sep;61(3):310-316. doi: 10.1016/j.jadohealth.2017.03.020. Epub 2017 Jun 3.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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