Prognosis in 41 severely malnourished anorexia nervosa patients.

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Date publication

octobre 2012

Auteurs

Membres identifiés du Cancéropôle Est :
Pr VERGES Bruno


Tous les auteurs :
Rigaud D, Tallonneau I, Brindisi MC, Verges B

Résumé

BACKGROUND & AIMS: To report the prognosis in 41 anorexia nervosa (AN) patients suffering from very severe malnutrition (mean BMI: 10.1 +/- 0.57 kg/m(2)). PATIENTS AND METHODS: Compared with 443 less malnourished AN patients, the 41 patients were older (27.8 +/- 5.4 vs 22.4 +/- 2.1 yrs), their AN was longer (9.6 +/- 3.4 vs 5.0 +/- 1.5 yrs) and more often of the restrictive subtype (P < 0.05). RESULTS: In 27% of the patients, all nutritional marker levels were in normal range. All patients received a prudent tube-refeeding: energy was increased from 12 to 40 kcal/kg/day, protein from 1.0 to 1.5 g/kg/day within 10 days. During stay, 1 patient died, 2 others suffered from myocardial infarction, 2 others from acute pancreatitis, and 5 from mental confusion. Compared with the other 443 AN patients, the 40 remaining patients had worse 6-yr prognosis: 2 died (7% vs 1.2%), 29% had severe outcome (vs 10%), and only 41% recovered (vs 62%). CONCLUSION: In AN patients with BMI < 11 kg/m(2), a prudent tube-refeeding could avoid short-term mortality, but long-term prognosis was bad.

Référence

Clin Nutr. 2012 Oct;31(5):693-8