Anne Song
Outcomes for Patients with Eating Disorders
Using a Standardized Inpatient Protocol
SchoolWestern Reserve Academy • Hudson, Ohio
ProgramScience Internship
MentorElaine E. Schulte, MD, MPH
DepartmentGeneral Pediatrics, Cleveland Clinic
- Research
- Outcomes for Patients with Eating Disorders Using a Standardized Inpatient Protocol
- Hypothesis
- The primary aim was to objectively evaluate the effectiveness of standardized protocols for inpatient treatment of patients with nutritional insufficiency (NI). It was hypothesized that the use of an inpatient protocol will prevent refeeding syndrome and sudden cardiac death, the most severe life-threatening medical consequences of NI.
- Methodology
- The medical records of all patients hospitalized at Cleveland Clinic Childrens’ Hospital in 2007 were reviewed for evidence of nutritional insufficiency, anorexia, bulimia, or eating disorder NOS. Hospital course and collected days to resolution of electrolyte abnormalities, bradycardia, orthostasis, and other factors were assessed. At discharge, variables noted on admission were documented, along with disposition and follow-up plan.
- Outcomes
- The use of an inpatient protocol appears to prevent refeeding syndrome and sudden cardiac death. Of the 22 patients hospitalized in 2007 with nutritional insufficiency, none suffered from refeeding syndrome or experienced sudden cardiac death. Most medical complications related to nutritional insufficiency were resolved in the patients before their respective discharges (85.5% resolution rate). In evaluating the effectiveness of a standardized protocol, modest weight, BMI, and percent ideal body weight increases were associated with the resolution of the most severe of the patients’ initial presenting medical complications.
