title: Prognosis in 41 severely malnourished anorexia nervosa patients.
abstract: OBJECTIVE
  To report the prognosis in 41 anorexia nervosa (AN) patients suffering from very severe malnutrition (mean BMI: 10.1 ± 0.57 kg/m(2)).
  
  
  METHODS
  Compared with 443 less malnourished AN patients, the 41 patients were older (27.8 ± 5.4 vs 22.4 ± 2.1 yrs), their AN was longer (9.6 ± 3.4 vs 5.0 ± 1.5 yrs) and more often of the restrictive subtype (P < 0.05).
  
  
  RESULTS
  In 27% of the patients, all nutritional marker levels were in normal range. All patients received a prudent tube-refeeding: energy was increased from 12 to 40 kcal/kg/day, protein from 1.0 to 1.5 g/kg/day within 10 days. During stay, 1 patient died, 2 others suffered from myocardial infarction, 2 others from acute pancreatitis, and 5 from mental confusion. Compared with the other 443 AN patients, the 40 remaining patients had worse 6-yr prognosis: 2 died (7% vs 1.2%), 29% had severe outcome (vs 10%), and only 41% recovered (vs 62%).
  
  
  CONCLUSIONS
  In AN patients with BMI < 11 kg/m(2), a prudent tube-refeeding could avoid short-term mortality, but long-term prognosis was bad.
authors.affiliation: Service d'Endocrinologie-Nutrition, CHU Le Bocage: 2, Bd du Maréchal de Lattre de Tassigny, 21000 Dijon, France. daniel.rigaud@chu-dijon.fr
authors.forename: Daniel
authors.initials: D
authors.lastname: Rigaud
authors.forename: Isabelle
authors.initials: I
authors.lastname: Tallonneau
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Brindisi
authors.forename: Bruno
authors.initials: B
authors.lastname: Vergès
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D015415:Biomarkers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D009203:Myocardial Infarction / Q000150:complications; D010195:Pancreatitis / Q000150:complications; D011379:Prognosis; D011502:Protein-Energy Malnutrition / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers