Medical outcomes for adults hospitalized with severe anorexia nervosa: An analysis by age group.
OBJECTIVE
Relatively little has been written about the outcomes of medical stabilization, analyzed specifically across the age spectrum, in adults with severe anorexia nervosa (AN).


METHODS
We retrospectively evaluated clinical parameters relevant to acuity of illness and outcomes of early refeeding in 142 adults with severe AN, admitted for definitive inpatient medical stabilization from October 1, 2008 to December 31, 2012. Patients were categorized into three age groups: 17 to 29, 30 to 40, and 41+ years.


RESULTS
The study included 142 patients with median age of 28 years old (range 17-65 years). Fifty-four percent (n = 78) were under 30 years old, 23% (n = 32) between 30 and 40 years old, and 23% (n = 32) were over 40 years old. Average admission BMI did not differ among age groups, ranging from 12.7 to 13.2 kg/m(2). Of the admission parameters, only low serum albumin levels (more prevalent in older patients), high international normalized ratio (INR) levels (more prevalent in younger patients), and neutropenia (more prevalent in the <30 age group) varied with age. During hospitalization, rates of bradycardia, hypoglycemia, liver dysfunction, very low %IBW, refeeding hypophosphatemia, refeeding edema, length of stay, and discharge BMI did not differ with age. Age group was associated with rate of weekly weight gain only in patients with AN-binge purge subtype.


CONCLUSIONS
Results demonstrate medical abnormalities and response to medical stabilization in severely ill AN patients during hospitalization were mostly similar across the age span. This information should allay fears that the effect of age will make medical stabilization more difficult.
Department of Medicine, University of Colorado, Denver, Colorado.|ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado.
Jennifer L
JL
Gaudiani
Department of Medicine, University of Colorado, Denver, Colorado.|ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado.
John T
JT
Brinton
Department of Patient Safety and Quality, Denver Health, Denver, Colorado.|Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Denver, Colorado.
Allison L
AL
Sabel
Department of Medicine, University of Colorado, Denver, Colorado.|ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado.|Department of Psychiatry, University of Colorado, Denver, Colorado.
Melanie
M
Rylander
University of Colorado School of Medicine, Denver, Colorado.
Brittany
B
Catanach
Department of Medicine, University of Colorado, Denver, Colorado.|ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado.|Eating Recovery Center, Denver, Colorado.
Philip S
PS
Mehler
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000856:Anorexia Nervosa / Q000150:complications / Q000628:therapy*; D015992:Body Mass Index; D002908:Chronic Disease; D005260:Female; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D017674:Hypophosphatemia / Q000209:etiology; D008107:Liver Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012189:Retrospective Studies; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult
adult; anorexia nervosa; eating disorder; medical stabilization; mid-life; middle age; older age; outcomes; refeeding; severe underweight