BACKGROUND Anorexia nervosa (AN) is a common eating disorder with the highest mortality rate of all psychiatric diseases. However, few studies have examined inpatient characteristics and treatment for AN. This study aimed to characterise the association between mortality and risk factors in patients with AN in acute-care hospitals. METHODS We conducted a nationwide, retrospective analysis of the Japanese Diagnosis and Procedure Combination inpatient database. Data extraction occurred from April 2010 to March 2016. We estimated in-hospital mortality and identified independent risk factors, using multivariate logistic regression analysis to examine patient characteristics and physical and psychological comorbidities. RESULTS We identified 6937 patients with AN aged ≥12 years in 885 acute-care hospitals. Of these, 361 (5.2%) were male. Male and female participants' median ages at first admission were 34 (17-65) and 28 (17-41) years, respectively. In total, 195 in-hospital patient deaths, including 22 (6.1%) men and 173 (2.6%) women, it was observed that the unadjusted odds ratio of mortality for male patients was more than twice that for female patients (OR: 2.40, 95% CI: 1.45-3.81). Multivariate logistic regression analysis demonstrated an adjusted odds ratio of 2.19 (95% CI: 1.29-3.73). Age at first hospital admission, percentage of ideal body weight, comorbidities, and hypotension were significantly associated with increased mortality risk, but the frequency of hospitalization, bradycardia, and other psychiatric disorders were not. Treatment in a university hospital was associated with lower mortality risk (odds ratio: 0.45, 95% CI: 0.30-0.67). CONCLUSION The results highlighted sex differences in mortality rates. Potential risk factors could contribute to improved treatment and outcomes. These retrospective findings indicate a need for further longitudinal examination of these patients.

中文翻译：

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急诊医院神经性厌食症的死亡率和风险评估：全国性行政数据库分析。

背景技术神经性厌食症（AN）是一种常见的饮食失调症，在所有精神疾病中死亡率最高。但是，很少有研究检查AN的住院特征和治疗。这项研究旨在表征急性护理医院AN患者的死亡率与危险因素之间的关联。方法我们对日本诊断和程序合并住院患者数据库进行了全国范围的回顾性分析。数据提取时间为2010年4月至2016年3月。我们使用多元logistic回归分析来评估患者的特征以及身体和心理上的合并症，从而估算出院内死亡率并确定独立的危险因素。结果我们在885家急诊医院中识别出6937名AN≥12岁的患者。其中361人（5.2％）是男性。首次入院的男性和女性参与者的中位年龄分别为34（17-65）岁和28（17-41）岁。总共有195例住院患者死亡，其中22例（6.1％）男性和173例（2.6％）女性死亡，据观察，男性患者的未调整死亡率比值是女性患者的两倍以上（OR：2.40 ，95％CI：1.45-3.81）。多元逻辑回归分析显示调整后的优势比为2.19（95％CI：1.29-3.73）。首次入院时的年龄，理想体重百分比，合并症和低血压与死亡风险增加显着相关，但住院，心动过缓和其他精神疾病的发生频率则不相关。在大学医院进行治疗与降低死亡风险相关（赔率：0.45，95％CI：0.30-0.67）。结论结果强调了死亡率的性别差异。潜在的危险因素可能有助于改善治疗效果和结果。这些回顾性发现表明需要对这些患者进行进一步的纵向检查。