Nutrition Approach for Inpatients With Anorexia Nervosa: Impact of a Clinical Refeeding Guideline.

Details

Serval ID
serval:BIB_118A83B0B2E5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Nutrition Approach for Inpatients With Anorexia Nervosa: Impact of a Clinical Refeeding Guideline.
Journal
JPEN. Journal of parenteral and enteral nutrition
Author(s)
Gjoertz M., Wang J., Chatelet S., Monney Chaubert C., Lier F., Ambresin A.E.
ISSN
1941-2444 (Electronic)
ISSN-L
0148-6071
Publication state
Published
Issued date
08/2020
Peer-reviewed
Oui
Volume
44
Number
6
Pages
1124-1139
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
This study assesses the impact of a clinical refeeding guideline on weight restoration, length of stay, rate of refeeding complications, and rehospitalizations.
This retrospective study included patient records of 107 participants aged 13-55 years with a diagnosis of AN, admitted for at least 7 days for renutrition before and after introduction of the refeeding guideline. Weight evolution graphs were rated by 2 clinical experts independently. Binary logistic regression models were erected to identify clinical outcomes associated independently with the guideline as well as to control for potential confounding by sociodemographic and clinical characteristics at admission.
The proportion of patients achieving optimal weight gain after the first 2 weeks increased significantly from 6.3% pre-guideline to 41.8% post guideline (adjusted odds ratio [AOR] = 37.6; 95% confidence interval [CI], 2.77-510.3; P = 0.006). Average length of hospitalization was reduced from 96.7 (SD 48.3) days pre-guideline to 62.2 (SD 45.5) days post guideline (AOR = 0.99; 95% CI, 0.97-1.01; P = 0.18). None of the patients developed a full refeeding syndrome. There was no significant change in the rate of rehospitalization: 48.5% pre-guideline to 43.2% post guideline (OR = 0.81; 95% CI, 0.36-1.84; P = 0.62).
The clinical guideline proved highly effective in bolstering weight gain via intensive refeeding procedures while also being safe. Harmonizing clinical practices improves quality of care for patients with anorexia and, interestingly, may decrease costs by cutting average length of stay by a third without increasing the rehospitalization rate.
Keywords
Adolescent, Adult, Anorexia Nervosa/therapy, Hospitalization, Humans, Inpatients, Middle Aged, Refeeding Syndrome/prevention & control, Retrospective Studies, Young Adult, anorexia nervosa, in-patients, length of stay, nutritional approach, refeeding guidelines, weight gain
Pubmed
Web of science
Open Access
Yes
Create date
20/11/2019 22:56
Last modification date
25/08/2021 5:38
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