[Results of nutritional treatment of anorexia nervosa: our experience (1989-1995)].
With the alm of evaluating the nutritional treatment of anorexia nervosa (AN) in our center, evolutive data were collected, as well as anthropometric and biochemical parameters, of out out patient department (OPD) as well as of our hospital admissions (HA) which took place between 1989-91 (period A) and between 1992-95 (period B). 79 cases of HA were included (5 men, 31 women), with a duration of hospitalization of 36.96 +/- 22.02 days, with the reason for release most often (86.84%) being reaching the agreed upon weight, and 124 cases of OPD (12 men and 112 women), who were followed for 11.53 +/- 12.13 months achieving a final release rate of 14.14%. The nutritional status (NS) of the HA patients upon admission was most often sever caloric malnutrition (CM) (64.55%), and upon release this was moderate CM (60.75%), while in the OPD the moderate CM was most frequent at the initial visit and at the last visit registered. The anthropometric parameter which was most affected, was the triceps fold (TF), followed by the wight (W). The biochemical abnormalities were few, with hypercholesterolemia and ferropenia being notable. The nutritional treatment in the OPD required the addition of dietary supplements in 31% of the cases, and of psycho-medication in 43%. In the HA cases, only 6 patients reached the agreed upon wight with a free oral diet, and 35 patients required dietary supplements, 20 needed mixed therapy (enteral nutrition and supplements), and 17 cases required enteral nutrition through a naso-gastric tube. Significant multivariant models are presented which find independent associations for the probability of release (lower age upon diagnosis, male, lower income, absence of bulimia's, no need for dietary supplements), of amenorrhoea (worse NS, absence of vomiting), and for the HA time (more interventionist treatment, lower weight, lower age). The comparison between periods, shows an initial contact of the patients with AN with our OPD, with a better nutritional status y recent years, as well as a better nutritional result, a greater tendency towards the use of enteral nutrition, and a shorter time of HA.
Martínez-Olmos
M A
MA
Unidad de Nutrición Clínica y Dietética, Hospital Universitario La Paz, Madrid, España.
Gómez-Candela
C
C
de Cos
A I
AI
González-Fernández
B
B
Iglesias
C
C
Hillman
N
N
Castillo
R
R
D000328:Adult; D000553:Ambulatory Care; D000568:Amenorrhea / Q000209:etiology; D000856:Anorexia Nervosa / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D001835:Body Weight; D004750:Enteral Nutrition; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009752:Nutritional Status; D018529:Nutritional Support; D013997:Time Factors
Resultado del tratamiento nutricional de la anorexia nervosa: nuestra experiencia (1989-1995).