Premature Mortality in Patients With Anorexia Nervosa: A Matched Cohort Study of Cause of Death.

IF 4.7 2区医学 Q1 NUTRITION & DIETETICS

International Journal of Eating Disorders Pub Date : 2025-04-02 DOI:10.1002/eat.24435

Nathalie Auger, Mimi Israël, Howard Steiger, Nancy Low, Nicholas Chadi, Émilie Brousseau, Aimina Ayoub, Gabriel Côté-Corriveau

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Abstract

Objective: To determine the extent to which anorexia nervosa is associated with premature mortality.

Method: We carried out a matched cohort study of 7332 male and female patients with anorexia nervosa and 73,215 patient controls who were admitted between 1989 and 2023 in hospital centers of Quebec, Canada. We tracked the patients longitudinally over time to identify premature deaths before age 75 years and determined the cause of death. We used stratified Cox regression models adjusted for patient characteristics to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between anorexia nervosa and premature mortality.

Results: Overall, 186 (2.5%) patients with anorexia nervosa and 615 (0.8%) matched controls died before age 75 years. Compared with no anorexia, anorexia nervosa was associated with 3.02 times the risk of premature mortality among females (95% CI 2.50-3.65) and 2.23 times the risk among males (95% CI 1.35-3.70). Patients with a first anorexia nervosa admission between age 20 and 29 years were most at risk of premature mortality (HR 8.00, 95% CI 4.30-14.88), as were patients hospitalized ≥ 3 times for anorexia nervosa (HR 4.72, 95% CI 3.25-6.84). Anorexia nervosa was associated with premature mortality due to metabolic and other endocrine disorders, suicide, and a range of other causes.

Discussion: Anorexia nervosa is associated with an elevated risk of premature mortality from metabolic disorders, suicide, and other causes. Patients who are female, hospitalized as young adults, or have repeated admissions for anorexia nervosa are most at risk.

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目的：确定神经性厌食症与过早死亡的关联程度：确定神经性厌食症与过早死亡的相关程度：我们对加拿大魁北克省医院中心 1989 年至 2023 年期间收治的 7332 名男女神经性厌食症患者和 73215 名对照组患者进行了匹配队列研究。我们对这些患者进行了长期纵向追踪，以发现 75 岁之前过早死亡的患者，并确定了死亡原因。我们使用根据患者特征调整的分层考克斯回归模型来估算神经性厌食症与过早死亡之间关系的危险比（HR）和 95% 置信区间（CI）：总体而言，186 名（2.5%）神经性厌食症患者和 615 名（0.8%）匹配对照组患者在 75 岁之前死亡。与未患厌食症的患者相比，神经性厌食症患者的过早死亡风险是女性患者的 3.02 倍（95% CI 2.50-3.65），是男性患者的 2.23 倍（95% CI 1.35-3.70）。首次因神经性厌食症入院的患者年龄在20至29岁之间，过早死亡的风险最大（HR 8.00，95% CI 4.30-14.88），因神经性厌食症住院≥3次的患者也是如此（HR 4.72，95% CI 3.25-6.84）。神经性厌食症与代谢紊乱和其他内分泌失调、自杀以及其他一系列原因导致的过早死亡有关：讨论：神经性厌食症与代谢紊乱、自杀和其他原因导致的过早死亡风险升高有关。女性、年轻时住院或因神经性厌食症反复住院的患者风险最高。

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来源期刊

International Journal of Eating Disorders 医学-精神病学

CiteScore

10.00

自引率

12.70%

发文量

204

审稿时长

4-8 weeks

期刊介绍： Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.