1003 – Extreme Anorexia Nervosa: Best Practices in Case Management and Complex Discharge
Patients suffering from anorexia nervosa have considerable mortality. Other than suicide, the second highest cause of mortality is medical complications, likely cardiac arrhythmias. Eating disorders affect 20 million women and 10 million men mainly between the ages of 15 to 30 years and despite their increasing prevalence, the medical community is generally unaware of first of all, how to diagnose such patients and secondly, how to treat the medical complications that arise from malnutrition. This leads to a delay in diagnosis and treatment which in turn leads to worse prognosis and outcomes. Malnutrition affects every organ system; patients often have marked vital sign abnormalities such as hypothermia, hypotension, and bradycardia, inflammation of the liver, hypoglycemia, bone marrow suppression, and electrolyte abnormalities. In addition, the period of time when starved individuals begin a nutritional rehabilitation can be deadly if the treating physicians are unaware of the management and prevention of refeeding syndrome. It is best and safest for patients to undergo refeeding syndrome and its complications in a specialized center that provides expert care in such a process and can anticipate and treat any consequences that arise.
Sadly, these patients often languish in med/surg hospitals due to lack of recognition and ability to manage their ensuing complications. In this presentation we will discuss the common medical presentations of these patients, medical management, and how to best triage the most appropriate level of care.
1. Learn the most common presentation of patients with severe malnutrition
2. Identify the most common medical complications of severe malnutrition due to anorexia nervosa and bulimia nervosa
3. Understand evidence-based management of severely malnourished patients.