Department of Pediatrics, University of California, San Francisco, California, USA.
Yale School of Public Health, Yale University, New Haven, Connecticut, USA.
Int J Eat Disord. 2022 Feb;55(2):247-253. doi: 10.1002/eat.23660. Epub 2021 Dec 26.
To determine sex differences in refeeding (i.e., short-term nutritional rehabilitation) outcomes among hospitalized adolescents and young adults with eating disorders.
We retrospectively reviewed electronic medical records of 601 patients aged 9-25 years admitted to the University of California, San Francisco Eating Disorders Program for medical and nutritional management between May 2012 and August 2020. Descriptive statistics, crude, and adjusted linear regression models were used to assess the association between sex and nutritional outcomes and predictors of length of stay.
A total of 588 adolescents and young adults met eligibility criteria (16% male, mean [SD] age 15.96 [2.75], 71.6% anorexia nervosa, admission percent median body mass index [%mBMI] 87.1 ± 14.1). In unadjusted comparisons, there were no significant sex differences in prescribed kilocalories (kcal) per day at admission (2013 vs. 1980, p = .188); however, males had higher estimated energy requirements (EER, kcal) (3,694 vs. 2,925, p < .001). In linear regression models adjusting for potential confounders, male sex was associated with higher prescribed kcals at discharge (B = 835 kcal, p < .001), greater weight change (B = 0.47 kg, p = .021), and longer length of stay (B = 1.94 days, p = .001) than females. Older age, lower admission weight, lower prescribed kcal at admission, higher EER, and lower heart rate at admission were factors associated with longer length of stay in a linear regression model.
These findings support the development of individualized approaches for males with eating disorders to improve quality of care and health care efficiency among an underserved population.
确定住院青少年和年轻患者在接受进食障碍治疗时短期营养康复结果的性别差异。
我们回顾性地分析了 2012 年 5 月至 2020 年 8 月期间，601 名在加利福尼亚大学旧金山进食障碍项目接受医疗和营养管理的 9-25 岁患者的电子病历。我们使用描述性统计、未经调整和调整后的线性回归模型来评估性别与营养结果之间的关联，以及预测住院时间长短的因素。
共有 588 名青少年和年轻患者符合入选标准（男性占 16%，平均年龄为 15.96 ± 2.75 岁，71.6%为神经性厌食症，入院时体重指数百分比中位数为 87.1 ± 14.1%）。在未调整的比较中，男女患者在入院时规定的每天卡路里摄入量（2013 年与 1980 年相比，p=0.188）方面没有显著差异；然而，男性的估计能量需求（EER，kcal）更高（3694 比 2925，p<0.001）。在调整潜在混杂因素的线性回归模型中，与女性相比，男性的性别与出院时规定的卡路里摄入量更高（B=835 kcal，p<0.001）、体重变化更大（B=0.47 kg，p=0.021）和住院时间更长（B=1.94 天，p=0.001）有关。线性回归模型中，年龄较大、入院体重较低、入院时规定的卡路里摄入量较低、EER 较高和入院时心率较低是与住院时间延长有关的因素。
这些发现支持为患有进食障碍的男性制定个性化的方法，以改善医疗服务质量和提高医疗服务效率，因为这些患者是一个未得到充分服务的群体。
