Pruccoli Jacopo, Pelusi Martina, Romagnoli Giorgia, Malaspina Elisabetta, Moscano Filomena, Parmeggiani Antonia
IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, U.O. di Neuropsichiatria dell'Età Pediatrica, 40138 Bologna, Italy.
Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy.
Brain Sci. 2021 Sep 19;11(9):1242. doi: 10.3390/brainsci11091242.
This study aims to investigate possible different outcomes in the inpatient treatment of anorexia nervosa (AN) related to different timings of psychopharmacological and nutritional interventions. A retrospective observational study was conducted, involving young patients hospitalized for AN, treated with naso-gastric tube feeding (NGT). Participants were divided into five groups according to early (0-7 days) or late (8+ days) introduction of atypical antipsychotics (AAP) and NGT: early AAP-early NGT (EE), early AAP-late NGT (EL), late AAP-early NGT (LE), late AAP-late NGT (LL) and a control group treated with NGT only (NGT). Concurrent clinical and treatment variables were analyzed. AN psychopathology was measured with the Eating Disorder Inventory-3 (EDI-3) EDRC score. Outcomes were assessed as admission-discharge body-mass index (BMI) improvement and length of hospital stay (LOS). Contributions of variables related to outcomes were assessed with multifactorial-analyses of variance (MANOVA). Seventy-nine patients were enrolled in the study. LOS was different among treatment groups (F (4, 75) = 5.993, < 0.001), and EE patients showed lower LOS than LE ( < 0.001) and LL ( = 0.025) patients. BMI improvement was not significantly different among treatment groups but correlated negatively with age (F (1, 72) = 10.130, = 0.002), and admission BMI (F (1, 72) = 14.681, < 0.001). In conclusion, patients treated with early AAP and early NGT showed lower LOS than those treated with late AAP. Prognostic treatment variables should be investigated in wider samples.
本研究旨在调查神经性厌食症（AN）住院治疗中，与精神药物和营养干预不同时机相关的可能不同结局。开展了一项回顾性观察研究，纳入因AN住院并接受鼻饲管喂养（NGT）治疗的年轻患者。参与者根据非典型抗精神病药物（AAP）和NGT的早期（0 - 7天）或晚期（8天及以后）引入分为五组：早期AAP - 早期NGT（EE）、早期AAP - 晚期NGT（EL）、晚期AAP - 早期NGT（LE）、晚期AAP - 晚期NGT（LL）以及仅接受NGT治疗的对照组（NGT）。分析了同时期的临床和治疗变量。用进食障碍问卷-3（EDI - 3）的进食障碍评定量表（EDRC）评分来衡量AN的精神病理学。结局评估为入院至出院时体重指数（BMI）的改善情况和住院时间（LOS）。通过多因素方差分析（MANOVA）评估与结局相关变量的作用。79名患者纳入本研究。治疗组之间的LOS存在差异（F(4, 75) = 5.993，P < 0.001），EE组患者的LOS低于LE组（P < 0.001）和LL组（P = 0.025）患者。治疗组之间BMI的改善无显著差异，但与年龄呈负相关（F(1, 72) = 10.130，P = 0.002），与入院时BMI呈负相关（F(1, 72) = 14.681，P < 0.001）。总之，早期使用AAP和早期使用NGT治疗的患者LOS低于晚期使用AAP治疗的患者。应在更大样本中研究预后治疗变量。
