1
|
Viaño-Nogueira P, Aparicio-López C, Prieto-Campo Á, Morón-Nozaleda G, Camarneiro-Silva R, Graell-Berna M, de Lucas-Collantes C. Hypercapnia in hospitalized children and adolescents with anorexia nervosa as a predictive marker for readmission: a prospective study. Eat Weight Disord 2023; 28:94. [PMID: 37921895 PMCID: PMC10624702 DOI: 10.1007/s40519-023-01624-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 10/29/2023] [Indexed: 11/05/2023] Open
Abstract
PURPOSE To determine whether hypercapnia is associated with risk of hospital readmission related to anorexia nervosa (AN) in children and adolescents. METHODS We performed a prospective study of patients ≤ 18 years old admitted due to AN decompensation from November 2018 to October 2019. Both subtypes of AN, restricting subtype (AN-R) and binge-eating/purging subtype (AN-BP), were included. Study participants were evaluated upon admission, at discharge and six months after discharge. T-tests or Mann-Whitney U tests was used to compare means values. Pearson or Spearman correlations were used to measure the association between two variables. Logistic regression models were developed to evaluate the relationship between scoring methods and readmission. RESULTS Of the 154 persons admitted during the study period, 131 met the inclusion criteria. Median age was 15.1 years. At admission, 71% of participants were malnourished and 33 (25%) had been previously admitted. We observed a marked decrease in venous pH and stable pCO2 elevation during follow-up period. Hypercapnia at discharge was associated with a twofold increased likelihood of readmission and the odds of readmission increased as discharge pCO2 rose. These findings did not depend on AN subtype or participant sex. Electrolytes persisted within the normal range. CONCLUSION Hypercapnia and respiratory acidosis are common alterations in children and adolescents hospitalized due to AN decompensation. Hypercapnia persists for at least 6 months after discharge despite clinical improvement and is associated with higher odds of readmission. This is the first study to identify an abnormal laboratory finding as a potential predictor of readmission in AN. LEVEL OF EVIDENCE IV: Multiple time series without intervention.
Collapse
Affiliation(s)
| | | | - Ángela Prieto-Campo
- Statistics and Methodology Unit, Galicia Sur Health Research Institute (ISS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | | | | | | | | |
Collapse
|
2
|
Lucas C, Brady J, Olympia RP. School Nurses on the Front Lines of Healthcare: Recognizing "BONES" and Knowing When to Pick Up the Phone: Eating Disorders Among Students in the School Setting. NASN Sch Nurse 2020; 37:83-88. [PMID: 32731791 DOI: 10.1177/1942602x20942531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Through a case presentation, this article describes the assessment and management of a student presenting with a history of disordered eating and weight loss. As medical concerns are brought to the attention of the school nurse, it is important for the school nurse to be aware of common signs and symptoms seen in students with undiagnosed or established eating disorders, as well as possible medical complications associated with untreated or poorly controlled eating disorders. Possible signs and symptoms associated with eating disorders that require outpatient referral or emergent management is delineated in this article, and school nurses are provided with a helpful mnemonic called "BONES" to aid in the recognition of eating disorders in the school setting.
Collapse
Affiliation(s)
- Christy Lucas
- Penn State University College of Medicine, Hershey, PA
| | - Jodi Brady
- Penn State University College of Medicine, Hershey, PA
| | - Robert P Olympia
- Professor, Departments of Emergency Medicine and Pediatrics, Penn State College of Medicine, Attending Pediatric Emergency Medicine physician, Penn State Hershey Medical Center, Hershey, PA
| |
Collapse
|
3
|
Coelho JS, Suen J, Clark BA, Marshall SK, Geller J, Lam PY. Eating Disorder Diagnoses and Symptom Presentation in Transgender Youth: a Scoping Review. Curr Psychiatry Rep 2019; 21:107. [PMID: 31617014 DOI: 10.1007/s11920-019-1097-x] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW This scoping review includes recent literature on eating disorder diagnoses and evaluation of eating disorder symptom presentation among transgender youth (ages 8-25). RECENT FINDINGS A total of 20 publications from the previous 5 years were identified, including case reports, retrospective chart reviews, and surveys. Significantly higher rates of eating disorder symptoms were documented in transgender youth compared to cisgender youth. Similarly, some studies reported transgender youth were more likely to be diagnosed with an eating disorder than cisgender youth, though the proportion of youth with eating disorder diagnoses varied across studies. A consistent theme across case studies was engagement in food restriction and/or compensatory eating behaviors to prevent puberty onset or progression, suggesting that for some transgender youth, these behaviors may be understood as a means of coping with gender-related distress. Clinical care could be enhanced through establishment of best practices for screening in settings offering eating disorder treatment and gender-affirming care, as well as greater collaboration among these programs. Research is needed to validate eating disorder measures for use with transgender youth and evaluate the effects of eating disorder treatment and gender-affirming medical interventions on the well-being of transgender youth.
Collapse
Affiliation(s)
- Jennifer S Coelho
- Provincial Specialized Eating Disorders Program for Children & Adolescents, BC Children's Hospital, Healthy Minds Centre, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada.
- Department of Psychiatry, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada.
| | - Janet Suen
- Provincial Specialized Eating Disorders Program for Children & Adolescents, BC Children's Hospital, Healthy Minds Centre, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Beth A Clark
- Allen-Berenson Fellow in Women's, Gender, and Sexuality Studies, Brandeis University, Waltham, MA, 02453, USA
| | - Sheila K Marshall
- School of Social Work, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
- Division of Adolescent Health & Medicine, Department of Pediatrics, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Josie Geller
- Department of Psychiatry, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
- Eating Disorders Program, St. Paul's Hospital, Vancouver, Canada
| | - Pei-Yoong Lam
- Provincial Specialized Eating Disorders Program for Children & Adolescents, BC Children's Hospital, Healthy Minds Centre, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Division of Adolescent Health & Medicine, Department of Pediatrics, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| |
Collapse
|
4
|
Couturier J, Kimber M, Barwick M, Woodford T, McVey G, Findlay S, Webb C, Niccols A, Lock J. Themes arising during implementation consultation with teams applying family-based treatment: a qualitative study. J Eat Disord 2018; 6:32. [PMID: 30410759 PMCID: PMC6211435 DOI: 10.1186/s40337-018-0218-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/11/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND This study describes themes arising during implementation consultation with teams providing Family-Based Treatment (FBT) to adolescents with eating disorders. METHODS Participants were implementation teams (one lead therapist, one medical practitioner and one administrator) at four sites. These teams agreed to support the implementation of FBT, and participated in monthly consultation calls which were audio-recorded, transcribed verbatim and coded for themes. Twenty percent of the transcripts were double-coded to ensure consistency. Fundamental qualitative description guided the sampling and data collection. RESULTS Twenty-five (average per site = 6) transcripts were coded using thematic content analysis. Six major themes emerged: 1) system barriers and facilitators 2) the role of the medical practitioner, 3) research implementation, 4) appropriate cases, 5) communication, and 6) program impact. CONCLUSIONS Implementation themes aligned with previous research examining the adoption of FBT, and provide additional insight for clinical programs seeking to implement FBT, emphasizing the importance of role clarity, and team communication.
Collapse
Affiliation(s)
- Jennifer Couturier
- 1Department of Psychiatry and Behavioural Neurosciences, McMaster Children's Hospital, McMaster University, 1200 Main St W, Hamilton, L8N 3Z5 Canada
| | - Melissa Kimber
- 2Offord Centre for Child Studies Suite 201A, McMaster University, 175 Longwood Rd S, Hamilton, L8P 0A1 Canada
| | - Melanie Barwick
- 3Research Institute, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8 Canada
| | - Tracy Woodford
- 4Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1200 Main St W, Hamilton, L8N 3Z5 Canada
| | - Gail McVey
- 5Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth St, Toronto, M5G 2C4 Canada
| | - Sheri Findlay
- 6Department of Pediatrics, McMaster Children's Hospital, McMaster University, 1200 Main St W, Hamilton, L8N 3Z5 Canada
| | - Cheryl Webb
- 7McMaster Children's Hospital, 1200 Main St W, Hamilton, L8N 3Z5 Canada
| | - Alison Niccols
- 2Offord Centre for Child Studies Suite 201A, McMaster University, 175 Longwood Rd S, Hamilton, L8P 0A1 Canada
| | - James Lock
- 8Department of Psychiatry & Neurosciences, Stanford University, Stanford, 401 Quarry Rd, Palo Alto, CA 94304 USA
| |
Collapse
|