title: ACUTE center for eating disorders.
abstract: BACKGROUND
  While patients with anorexia nervosa have a high mortality rate, more are living into adulthood. Patients with severe malnutrition secondary to anorexia nervosa often require hospitalization for medical stabilization prior to treatment in eating disorders programs.
  
  
  METHODS
  We developed the ACUTE Center at Denver Health Medical Center to medically stabilize adults with the medical complications of severe malnutrition due to an eating disorder. The first 2 years of patient characteristics and outcomes are reported.
  
  
  RESULTS
  From October 2008 through December 2010, the ACUTE unit had 76 admissions of which 62 were for medical stabilization, comprising 54 patients. Eighty-nine percent of patients were female. The mean age was 27 years old (range 17-65). The mean body mass index on admission was 12.9 kg/m(2) (standard deviation [SD] 2.0). At admission, patients were hyponatremic, anemic, and leukopenic, with low bone density, but had normal albumin levels. The mean body mass index on discharge was 13.1 ± 1.9 kg/m(2). Median length of stay was 16 days (interquartile range [IQR] 9-29 days). Eighteen percent were discharged to home and eighty-two percent were discharged to inpatient psychiatric eating disorder units. Inpatient mortality was zero.
  
  
  CONCLUSIONS
  Patients with this degree of severe malnutrition due to eating disorders are medically complex and relatively uncommon. Regionalized subspecialty centers of excellence, in which a multidisciplinary team is led by practitioners of hospital medicine who have developed expertise in a rare condition, may improve clinical outcomes, optimize healthcare resources, and provide unique professional and academic opportunities for the clinicians involved.
authors.affiliation: Division of Hospital Medicine, Department of Medicine, Boulder Community Hospital, Denver, Colorado, USA.
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Chu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Gaudiani
authors.forename: Margherita
authors.initials: M
authors.lastname: Mascolo
authors.forename: Barbara
authors.initials: B
authors.lastname: Statland
authors.forename: Allison
authors.initials: A
authors.lastname: Sabel
authors.forename: Kim
authors.initials: K
authors.lastname: Carroll
authors.forename: Philip S
authors.initials: PS
authors.lastname: Mehler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D055815:Young Adult