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限制性进食障碍儿科医疗稳定住院结局：多中心评估

Outcomes of paediatric medical stabilisation admissions for restrictive eating disorders: a multicentre evaluation
RSS 订阅 · Archives of Disease in Childhood

本研究为英国两家医院85名0-18岁限制性进食障碍儿童及青少年的回顾性队列分析，描述其住院稳定治疗的人群特征与关键结局。结果显示，最常见诊断为神经性厌食，多数患儿出院至社区治疗，约1/4存在医疗不稳定。研究为制定多中心标准数据集提供基线数据，并有助于向患儿及家庭提供咨询。

要点

  • 最常见诊断是神经性厌食（占48.8%）
  • 24.1%发生生化性再喂养综合征
  • 神经性厌食或入院时较低BMI中位数百分比与转住院治疗相关

核心结论

  • 本多中心回顾性研究为限制性进食障碍儿科住院稳定治疗提供了关键结局基线数据
  • 神经性厌食诊断和较低入院BMI中位数百分比与转至进一步住院治疗相关（p<0.05）

研究设计与样本

  • 英国2家医院85例0-18岁限制性进食障碍患儿回顾性队列分析
  • 纳入2018年1月至2022年9月住院时间>1天的限制性进食障碍患儿

主要发现

  • 中位年龄15.1岁（IQR=2.7），女性占85.9%（n=73）
  • 最常见诊断：神经性厌食48.8%（n=41）
  • 25.9%（n=22）存在医疗不稳定
  • 中位住院时长21.0天（IQR=23.0）
  • 出院至社区治疗最常见（61.4%，n=51）

关键数值与推荐

  • 生化性再喂养综合征发生率24.1%（n=20）
  • 诊断为神经性厌食或入院时较低BMI中位数百分比与转住院治疗相关（p<0.05）

临床怎么用

  • 提供基线结局数据以建立多中心标准数据集
  • 可用于向患儿及家属提供入院住院治疗的咨询参考

局限性

  • 样本量较小（85例）
  • 仅覆盖英国两家医院
  • 研究时期（2018-2022）可能影响结果外推性

以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。

原文

Eating disorders (ED) are associated with mortality and morbidity. The outcomes of a short refeeding admission on a paediatric ward have not previously been evaluated in a UK setting. The aim was to describe the patient population and identify key outcomes to develop a standard data set. A retrospective cohort analysis of 85 children and young people (CYP) from 2 UK hospitals. Patients included were 0–18 years, admitted for a restrictive ED from January 2018 to September 2022 where length of stay was >1 day. Cases were most often midadolescent (15.1 years, IQR=2.7) females (n=73, 85.9%) and the most common diagnosis was anorexia nervosa (AN)—(n=41, 48.8%). Discharge to community treatment was the most common outcome (n=51, 61.4%) with the remainder transferred to onward inpatient care. Medical instability was present in n=22 (25.9%). The median length of stay was 21.0 days (IQR=23.0). Nutritional supplements were required for one in three CYP either orally (n=30, 36.1%) or via a nasogastric tube (n=25, 30.1%). Biochemical refeeding syndrome was seen in n=20 (24.1%). A diagnosis of AN or lower % median body mass index on admission was both associated with transfer for further inpatient care (p<0.05). This study provides baseline data of core outcomes to inform a multicentre dataset and offer valuable information when counselling CYP and families. It also provides services with baseline outcomes to work to improve the care and outcomes of CYP with restrictive EDs.

来源：Archives of Disease in Childhood，查看原文。版权归原作者所有。

引用

  1. Archives of Disease in Childhood：Outcomes of paediatric medical stabilisation admissions for restrictive eating disorders: a multicentre evaluation
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供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。