Kurata Kazumi, Inagawa Yuta, Yagihashi Tatsuhiko, Nakamura Takahiro, Obi Seiji, Suda Shiro
Department of Psychiatry, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0498, Japan.
Eat Weight Disord. 2025 Mar 21;30(1):29. doi: 10.1007/s40519-025-01736-1.
There is no consensus regarding the optimal target weight for discharge during the hospitalization of children with eating disorders (EDs). We attempted to identify the ideal discharge weight for children receiving their first inpatient treatment for anorexia nervosa (AN) or avoidant/restrictive food intake disorder (ARFID).
Sixty children (mean age: 12.8 years) diagnosed with either AN (49 children) or ARFID (11 children) were followed for 1 year after discharge from a psychiatric ward. We analyzed the percent of ideal body weight (%IBW) at discharge, along with physical and social factors, to predict weight outcomes and rehospitalization risk during the first year after discharge. Longitudinal weight trends were assessed, and Cox proportional hazards modeling was used to analyze the time to rehospitalization.
Single and multiple regression analyses identified the %IBW at discharge as the sole significant predictor of %IBW at 1 year. A receiver operating characteristic curve determined that 86.4%IBW at discharge was the optimal predictor of achieving 90%IBW by 1-year post-discharge. Patients who had achieved ≥ 86.4%IBW at discharge showed better weight trajectories compared with those discharged at < 86.4%IBW. A higher discharge %IBW was associated with prolonged time to rehospitalization, indicating a reduced risk of readmission.
Discharging pediatric patients at a higher weight is associated with improved weight recovery and a reduced risk of rehospitalization. A target discharge weight of 86.4%IBW may serve as an effective criterion for children with EDs.
III, case-control analytic studies.
对于饮食失调（ED）儿童住院期间的最佳出院目标体重，目前尚无共识。我们试图确定首次接受神经性厌食症（AN）或回避/限制性食物摄入障碍（ARFID）住院治疗的儿童的理想出院体重。
60名被诊断为AN（49名儿童）或ARFID（11名儿童）的儿童在从精神科病房出院后随访1年。我们分析了出院时的理想体重百分比（%IBW）以及身体和社会因素，以预测出院后第一年的体重结果和再次住院风险。评估了纵向体重趋势，并使用Cox比例风险模型分析再次住院时间。
单因素和多因素回归分析确定出院时的%IBW是1年时%IBW的唯一显著预测因素。受试者工作特征曲线确定出院时86.4%IBW是出院后1年达到90%IBW的最佳预测指标。出院时达到≥86.4%IBW的患者与出院时<86.4%IBW的患者相比，体重轨迹更好。出院时较高的%IBW与再次住院时间延长相关，表明再入院风险降低。
较高体重出院的儿科患者体重恢复情况更好，再次住院风险降低。86.4%IBW的出院目标体重可作为ED儿童的有效标准。
III，病例对照分析研究。
