Redekopp Carlie, Dimitropoulos Gina, Patten Scott, Kassam Aliya
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada.
Int J Eat Disord. 2022 Sep;55(9):1219-1228. doi: 10.1002/eat.23588. Epub 2021 Jul 26.
While screening tools are available for the early identification of eating disorders, it may not be feasible to employ them in an emergency department (ED). Establishing a risk profile may improve the screening process. The purpose of this study was to investigate ED service utilization among patients with eating disorders and create a risk profile to help detect eating disorders at an earlier and more treatable stage.
We applied a concurrent mixed methods research design, however, only the quantitative findings will be presented. Our study involved a retrospective cohort analysis of administrative ED health data for patients (n = 243) aged 12-24 years in an eating disorders program. Two control groups: (1) all-cause (n = 716), (2) and mental health (n = 679) were included.
68.7% of eating disorder patients were discharged from the ED without follow-up being arranged. Comorbidities were recorded as the primary or secondary diagnosis, and patients presented with suicidality more frequently than controls (χ = 31.2, p < .001). Patients accessed ED services five times more often than controls.
Despite eating disorder patients accessing the ED more frequently than controls, eating disorder diagnoses were not always assigned or documented. Our findings highlight the importance of enhanced eating disorder training for ED health care staff to better understand the risk profile, and the consideration of comorbidities and suicide risk when assessing patients to ensure early detection.
As eating disorders are often undetected, more comprehensive training and access to screening tools may help improve detection, mitigate symptom progression, and enhance patient safety.
虽然有筛查工具可用于早期识别饮食失调症，但在急诊科使用这些工具可能并不可行。建立风险概况可能会改善筛查过程。本研究的目的是调查饮食失调症患者的急诊科服务利用情况，并创建一个风险概况，以帮助在更早且更易治疗的阶段检测出饮食失调症。
我们采用了同步混合方法研究设计，不过，仅呈现定量研究结果。我们的研究涉及对一个饮食失调项目中12至24岁患者（n = 243）的急诊科行政健康数据进行回顾性队列分析。纳入了两个对照组：（1）全病因组（n = 716），（2）心理健康组（n = 679）。
68.7%的饮食失调症患者从急诊科出院时未安排后续跟进。共病被记录为主要或次要诊断，且患者出现自杀倾向的频率高于对照组（χ = 31.2，p < .001）。患者使用急诊科服务的频率是对照组的五倍。
尽管饮食失调症患者比对照组更频繁地前往急诊科，但饮食失调症的诊断并非总是被确定或记录。我们的研究结果凸显了对急诊科医护人员加强饮食失调症培训的重要性，以便更好地了解风险概况，以及在评估患者时考虑共病和自杀风险以确保早期发现。
由于饮食失调症常常未被发现，更全面的培训和获取筛查工具可能有助于改善检测、减轻症状进展并提高患者安全性。
