Retrospective analysis of hypophosphatemia rates and other clinical parameters in patients with eating disorders

• Published in: European eating disorders review 2021-03, Vol.29 (2), p.193-203
• Main Authors: Richardson, Candice, Huniewicz, Paulina, Paslakis, Georgios
• Format: Article
• Language: English
• Subjects: anorexia nervosa; Body mass index; bulimia nervosa; comorbidity; Eating disorders; psychotherapy; re‐feeding
• ISSN: 1072-4133; 1099-0968
• DOI: 10.1002/erv.2810

Objective To retrospectively assess medical services of a specialist inpatient eating disorders (EDs) unit. Method We retrospectively evaluated clinical parameters of 288 inpatients classified as ‘moderately’ or ‘significantly’ medically compromised between 1 January 2016 and 30 June 2019. Results We analysed 288 patients (mean age 32.5 [SD = 11.4] years, 96% women, 76% with anorexia nervosa). Average length of stay was 38.4 (SD = 28.4) days. Average admission body mass index (BMI) was 14.8 (SD = 1.8) kg/m2, and 16.1 (SD = 1.9) kg/m2 at 4 weeks. At admission, 82% of patients were considered significantly medically compromised, while 6% were deemed moderately compromised. Only 5% of patients required transfer to intensive care unit. Prevalence of hypophosphatemia was 17.7%; rates did not increase significantly between years despite more assertive re‐feeding processes. There was no association between risk classification at admission and change in BMI at 4 weeks (F(2,166) = 0.588, p = 0.557). BMI at admission was found to be significantly associated with clinical outcome (β = 0.92, p < 0.001). Discussion Hypophosphatemia rates did not increase despite more assertive re‐feeding over 3 years. Our results provide support for a model of treatment that simultaneously addresses the medical and psychiatric sequelae of patients with severe EDs. Highlights We describe the clinical presentations of n = 288 adults with EDs admitted with medical complications to a specialist inpatient service and compare these clinical parameters from 2016 to 2019. At admission, 82% of patients were considered significantly medically compromised, while 6% were deemed moderately compromised As a main finding, assertive increases in rates of re‐feeding over the years did not negatively affect the risk of hypophosphatemia; the prevalence of hypophosphatemia was 17.7% Our results provide support for a model of treatment that simultaneously addresses the medical and psychiatric sequelae of patients with severe EDs