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Journal article
Outcomes of an inpatient refeeding protocol in youth with Anorexia Nervosa and atypical Anorexia Nervosa at Children's Hospitals and Clinics of Minnesota
Journal of eating disorders, v 4(1), pp 35-35
19 Dec 2016
PMCID: PMC5165845
PMID: 28018595
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Historically, inpatient protocols have adopted relatively conservative approaches to refeeding in Anorexia Nervosa (AN) in order to reduce the risk of refeeding syndrome, a potentially fatal constellation of symptoms. However, increasing evidence suggests that patients with AN can tolerate higher caloric prescriptions during treatment, which may result in prevention of initial weight loss, shorter hospital stays, and less exposure to the effects of severe malnutrition. Therefore the present study sought to examine the effectiveness of a more accelerated refeeding protocol in an inpatient AN and atypical AN sample.
Methods: Participants were youth (ages 10-22) with AN (n = 113) and atypical AN (n = 16) who were hospitalized for medical stabilization. A retrospective chart review was conducted to assess changes in calories, weight status (percentage of median BMI, % mBMI), and indicators of refeeding syndrome, specifically hypophosphatemia, during hospitalization. Weight was assessed again approximately 4 weeks after discharge.
Results: No cases of refeeding syndrome were observed, though 47.3 % of participants evidenced hypophosphatemia during treatment. Phosphorous levels were monitored in all participants, and 77.5 % were prescribed supplemental phosphorous at the time of discharge. Higher rates of caloric changes were predictive of greater changes in % mBMI during hospitalization. Rates of caloric and weight change were not related to an increased likelihood of re-admission.
Conclusions: Results suggest that a more accelerated approach to inpatient refeeding in youth with AN and atypical AN can be safely implemented and is not associated with refeeding syndrome, provided there is close monitoring and correction of electrolytes. These findings suggest that this approach has the potential to decrease length of stay and burden associated with inpatient hospitalization, while supporting continued progress after hospitalization.
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Details
- Title
- Outcomes of an inpatient refeeding protocol in youth with Anorexia Nervosa and atypical Anorexia Nervosa at Children's Hospitals and Clinics of Minnesota
- Creators
- Kathryn Smith - Neuropsychiatric Research InstituteJulie Lesser - Children's Hospitals and Clinics of MinnesotaBeth Brandenburg - Children's Hospitals and Clinics of MinnesotaAndrew Lesser - Children's Hospital of PhiladelphiaJessica Cici - Fairview Health ServicesRobert Juenneman - Children's Hospitals and Clinics of MinnesotaAmy Beadle - Children's Hospitals and Clinics of MinnesotaSarah Eckhardt - Children's Hospitals and Clinics of MinnesotaElin Lantz - Drexel UniversityJames Lock - Stanford UniversityDaniel Le Grange - University of California, San FranciscoKeisha A Smith - School of Education (1997-)
- Publication Details
- Journal of eating disorders, v 4(1), pp 35-35
- Publisher
- Springer Nature
- Number of pages
- 11
- Grant note
- Children's Hospitals and Clinics of Minnesota
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Education
- Web of Science ID
- WOS:000395729700001
- Scopus ID
- 2-s2.0-85006391427
- Other Identifier
- 991019173735204721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Nutrition & Dietetics
- Psychiatry
- Psychology, Clinical