Postdischarge Mortality in a Cohort Hospitalized With Anorexia Nervosa

IF 4.7 2区医学 Q1 NUTRITION & DIETETICS International Journal of Eating Disorders Pub Date : 2024-09-26 DOI:10.1002/eat.24296

Scott B. Patten, Gina Dimitropoulos, Julia Hews-Girard, Amelia Austin, Vandad Sharifi, Jeanne Williams, Anees Bahji, Andrew Bulloch

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Abstract

Objective

To characterize mortality after hospital discharge in cohorts with and without anorexia nervosa (AN).

Methods

We obtained data for all hospitalizations for psychiatric reasons in Canada (except Quebec) between April 1, 2006, and March 31, 2021 (n = 1.3 million admissions). Cases of AN were identified using ICD-10 (F50.0 and F50.1) codes. First admissions during this interval for AN and other psychiatric conditions were linked to vital statistics data. Mortality was characterized through cross-tabulation, Cox proportional hazards models, and competing cause regression.

Results

After adjustment for age and sex, there was no significant difference in mortality between AN and those with other psychiatric conditions (HR = 1.04; p = 0.644). Among AN admissions, 25% (95% CI 18.6–31.4) of deaths were attributed to psychiatric conditions (ICD-F codes), with 88% of these (comprising 22% of all deaths in the AN group) having AN itself identified as the underlying cause of death. In contrast, only 8% of deaths among non-AN admissions were attributed to a mental disorder.

Discussion

Prevention of premature mortality in the general psychiatric population emphasizes modification of metabolic (e.g., hyperlipidemia) and lifestyle-related (e.g., sedentary behavior) risk factors. However, as AN itself makes a major contribution to mortality, specialized preventive strategies may be required.

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神经性厌食症住院病人出院后的死亡率。

目的：分析神经性厌食症（AN）患者和非厌食症患者出院后的死亡率特征：描述神经性厌食症（AN）患者和非厌食症患者出院后的死亡率特征：我们获得了 2006 年 4 月 1 日至 2021 年 3 月 31 日期间加拿大（魁北克除外）所有因精神疾病住院的数据（n = 130 万入院人数）。AN病例使用ICD-10（F50.0和F50.1）代码进行识别。在此期间因 AN 和其他精神疾病而首次入院的病例与生命统计数据相关联。通过交叉表、Cox比例危险模型和竞争原因回归分析了死亡率的特征：结果：在对年龄和性别进行调整后，躁狂症患者和其他精神疾病患者的死亡率没有明显差异（HR = 1.04; p = 0.644）。在入院的自闭症患者中，25%（95% CI 18.6-31.4）的死亡归因于精神疾病（ICD-F代码），其中88%（占自闭症组所有死亡人数的22%）的根本死因是自闭症。相比之下，在非焦虑症入院患者中，只有8%的死亡归因于精神障碍：讨论：预防普通精神病患者过早死亡的重点在于改变代谢（如高脂血症）和生活方式（如久坐不动）相关的风险因素。然而，由于焦虑症本身是导致死亡率的主要因素，因此可能需要专门的预防策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Eating Disorders 医学-精神病学

CiteScore

10.00

自引率

12.70%

发文量

204

审稿时长

4-8 weeks

期刊介绍： Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.