Table 6.
Studies in patients with anorexia nervosa reporting clinical outcomes of the nutritional treatment.
| Study | Study Type | Nº Patients | Mean Age (years) | Weight (kg) or BMI (kg/m2) at Admission | Weight (kg) or BMI (kg/m2) at Discharge | Length of Stay (days) | Kcal/kg or kcal/day at Admission | Type of Nutritional Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|
| Rigaud et al., 2007 [25] | RCT a: TF b: control |
a: 41 b: 40 |
a: 22.5 b: 24.2 |
a: 12.1 b: 12.8 |
a: 17.9 b: 15.9 |
60 | a: 1000 (D0)–2450 (D14) b: 1000 (D0)–1850 (D14) |
a: OD + TF b: OD |
No RS 1-year relapse: a: 44% b: 52% |
| Diamanti et al., 2008 [44] | Retrospective | a: 104 b: 94 |
15 | a: 36.3 b: 41 |
a: 39.6 b: 41.5 |
a: 30.7 b: 15.6 |
40 kcal/kg | a: OD + PN b: OD |
No RS a: Hypophosphataemia (6 cases), Hypopotassaemia (3 cases) |
| Gentile et al., 2010 [26] | Retrospective | 33 | 22.8 | 11.3 | 13.5 | 60 | 1408 | OD + TF + iv. glucose | No RS |
| Vignaud et al., 2010 [33] | Retrospective | 68 | 31 | 12 | - | 7.6 (in ICU) | 22.3 kcal/kg | OD + TF + TPN | RS (10%) Mortality (10%) |
| Whitelaw et al., 2010 [34] | Retrospective | 29 | 15.7 | 72.9% IBW | - | - | 1900–2200 (89% of patients) | OD + ONS + TF (7 patients) | Mild hypophosphataemia (37%) |
| Garber et al., 2012 [35] | Prospective | 35 | 16.2 | 16.3 | - | 17 | 1205 | OD | No RS Hypophosphataemia (20%) |
| Gentile et al., 2012 [36] | Retrospective | 10 | 22 | 11.2 | 17.3 | 90 | 1199 | OD + TF + iv. glucose | No RS |
| Agostino et al., 2013 [37] | Retrospective cohort study: a: Nasogastric cohort b: bolus-fed cohort |
165 | 14.9 | a: 16.6 b: 16.7 |
- | a: 33.8 b: 50.9 |
a: 1617 b: 1069 |
a: 31 patients b: 134 patients |
No RS a: Hypopotassaemia (1 case); readmissions at 6 months (12.9%) b: Hypopotassaemia (1 case); mild-moderate hypophosphataemia (8 cases); readmissions at 6 months (23%) |
| Garber et al., 2013 [38] | Prospective cohort: a: high calorie b: low calorie |
56 | 16.2 | a: 16.6 b: 15.8 |
- | 14.9 | a: 1700 b: 1093 |
OD + ONS | No RS Hypophosphataemia (45%) Length of stay: a: 11.9 days b: 17.6 days |
| Golden et al., 2013 [39] | Retrospective a: low calorie b: high calorie |
a: 88 b: 222 |
16.1 | a: 15.9 b: 16.1 |
a: 17.2 b: 17.1 |
a: 16.6 b: 13 |
a: 1163 b: 1557 |
OD + ONS + TF (occasionally) | No RS Hypophosphataemia (15.8%) Hypomagnesaemia (15.2%) Hypopotassaemia (20%) |
| Leclerc et al., 2013 [40] | Retrospective | 29 | 14.7 | 16.4 | - | 35.8 | 1500 | OD + ONS | Hypophosphataemia (3.5%) |
| Hofer et al., 2014 [27] | Retrospective | 65 | 27.9 | 13.7 | 15 | 49.5 | 10 kcal/kg | OD (mostly) OD + ONS (8.1%) OD + TF (8.1%) TF (5%) OD + TPN (1.2%) |
Mild RS (10.5%) Severe hypopotassaemia (4.7%) |
| Brown et al., 2015 [28] | Retrospective case-control | 123 | 28 | 13 | 13.9 | 13 | 1200 | OD | Hypophosphataemia (33%) |
| O’Connor et al., 2016 [61] | RCT a: intervention b: control |
a: 18 b: 18 |
13.8 | a: 32.4 b: 34.6 |
a: 34.1 b: 35.6 |
10 | a: 38 kcal/kg/d b: 16 kcal/kg/d |
OD + TF | a: Hypophosphataemia (28%) b: Hypophosphataemia (11%) |
| Marugán et al., 2016 [29] | Retrospective | 50 | 14.5 | 15.45 | 17.58 | 44.54 | 1000 | OD ONS (16%) TF (8%) |
No symptoms of RS |
| Kameoka et al., 2016 [30] | Retrospective | 99 | 30.9 | <17.5 | - | 82.7 | Low calorie diet | OD | Hypophosphataemia (21.2%) |
| Smith et al., 2016 [62] | Retrospective | 129 | 15.8 | 15.8 | 17.1 | 14.9 | 1585 | OD + ONS | No RS Hypophosphataemia (47.3%) Hypokalaemia (12%) |
| Davies et al., 2017 [31] | Retrospective | 65 | 24 | 12.8 | 14.4 | 60 | 20-30 | OD, ONS (infrequently) | Mild hypophosphataemia (<0.8 mmol/L) (6.5%) Hypokalaemia (1 case). No RS |
| Peebles et al., 2017 [32] | Retrospective | 215 | 15.3 | 17.1 | 18.2 | 11 | 1466 | OD, TF (10%) | No RF. Hypophosphataemia (14%) 3.8% and 17.2% rehospitalisations after 30 days and 1 year, respectively |
TF: Tube Feeding, OR: Oral Diet, ONS: Oral Nutritional Supplements, RS: Refeeding Syndrome, PN: Parenteral Nutrition, TPN: Total Parenteral Nutrition, RCT: Randomised Controlled Trial.