Date of Award

Summer 6-30-2016

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Nutrition

First Advisor

Anita M. Nucci, PhD, RD, LD

Second Advisor

Leslie Cox, MS, RD, CSP, LD

Third Advisor

Sarah T. Henes, PhD, RD, LD

Abstract

Background: Hospitalizations including the diagnosis of an eating disorder (ED) have increased significantly in the pediatric population over the past few decades. Patients who are male, who areage, who receive an nasogastric (NG) tube, or who require admission to a residential treatment program often remain in the hospital for longer periods of time. Few studies examining LOS exist for children and adolescents with an ED. Longer lengths of stay have previously been associated with factors such as having Medicaid, a reduced body mass index (BMI) upon admission, and a diagnosis of anorexia nervosa (AN).

Objective: The purpose of this study is to examine risk factors related to a longer LOS in children and adolescents admitted to a large urban pediatric hospital with AN or bulimia nervosa (BN).

Participants/setting: A retrospective cohort study was conducted in 65 patients 9-20 years of age who were admitted to Children’s Healthcare of Atlanta (CHOA) between January 1, 2014 and December 31, 2015.

Statistical Analysis: Frequency statistics were used to describe the demographic, anthropometric, and clinical characteristics of the population. A Mann Whitney U test or Kruskal-Walllis test was used to examine differences in LOS by demographic characteristics, mode of nutrition therapy, discharge treatment program location, and admission BMI category. The association between LOS category by demographic and clinical characteristics was determined using a Chi-square statistic.

Results: A total of 65 patients (94% female, 89% Caucasian) with a mean age of 14.6 ± 2.4 years were admitted during the study period. The median LOS was 9 days (IQR; 6, 13) and was significantly longer in those who had an NG tube placed vs. oral diet (11 days (IQR; 7, 21) vs. 8 days (IQR; 5, 9.3), respectively; p

Conclusion: The characteristics of hospitalized pediatric patients with an ED were consistent with those of other studies. Longer lengths of stay in those who had an NG tube placed may have been due to the patient’s lack of compliance, failure to gain weight, and severity of malnutrition since more time is needed for medical recovery. More treatment centers for children and adolescents with an ED are needed in the state of Georgia to potentially reduce LOS. Future studies should include a greater percentage of males and larger population of children and adolescents.

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