Abstract
BackgroundAnorexia nervosa (AN) is a common eating disorder with the highest mortality rate of all psychiatric diseases. However, few studies have examined inpatient characteristics and treatment for AN. This study aimed to characterise the association between mortality and risk factors in patients with AN in acute-care hospitals.MethodsWe conducted a nationwide, retrospective analysis of the Japanese Diagnosis and Procedure Combination inpatient database. Data extraction occurred from April 2010 to March 2016. We estimated in–hospital mortality and identified independent risk factors, using multivariate logistic regression analysis to examine patient characteristics and physical and psychological comorbidities.ResultsWe identified 6937 patients with AN aged ≥12 years in 885 acute-care hospitals. Of these, 361 (5.2%) were male. Male and female participants’ median ages at first admission were 34 (17–65) and 28 (17–41) years, respectively. In total, 195 in-hospital patient deaths, including 22 (6.1%) men and 173 (2.6%) women, it was observed that the unadjusted odds ratio of mortality for male patients was more than twice that for female patients (OR: 2.40, 95% CI: 1.45–3.81). Multivariate logistic regression analysis demonstrated an adjusted odds ratio of 2.19 (95% CI: 1.29–3.73). Age at first hospital admission, percentage of ideal body weight, comorbidities, and hypotension were significantly associated with increased mortality risk, but the frequency of hospitalization, bradycardia, and other psychiatric disorders were not. Treatment in a university hospital was associated with lower mortality risk (odds ratio: 0.45, 95% CI: 0.30–0.67).ConclusionThe results highlighted sex differences in mortality rates. Potential risk factors could contribute to improved treatment and outcomes. These retrospective findings indicate a need for further longitudinal examination of these patients.
Highlights
Anorexia nervosa (AN) is a common eating disorder with the highest mortality rate of all psychiatric diseases
When their physical conditions are severe, initial treatment is often provided by internal medicine or critical care physicians who are accustomed to using hemodynamic agents
Over seven years, 6937 patients from 885 hospitals met the inclusion criteria. They represented 11066 hospitalisation occurrences; 9165 (82.8%) occurrences were for psychiatric reasons and 1901 (17.2%) were for medical/ surgical reasons
Summary
Anorexia nervosa (AN) is a common eating disorder with the highest mortality rate of all psychiatric diseases. Anorexia nervosa (AN) is a common eating disorder It is observed mainly in women aged 10–20 years and is associated with high levels of psychological stress or anxiety related to the pursuit of thinness or fear of fatness [1]. These stress are anxiety are specific to this age group. Once patients fail to respond to these initial interventions and demonstrate physical or psychiatric instability, hospitalisation is recommended When their physical conditions are severe, initial treatment is often provided by internal medicine or critical care physicians who are accustomed to using hemodynamic agents
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