{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:13:55Z","timestamp":1790734435036,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Anorexia nervosa (AN) is associated with one of the highest\u00a0mortality\u00a0rates of any psychiatric disorder but limited mortality data were reported for those with extremely severe malnutrition. This study aimed to estimate standardized\u00a0mortality\u00a0ratio (SMR), investigate predictive factors of mortality and causes of death among a sample of patients with AN admitted to a specialized clinical nutrition unit (CNU) because of extremely severe malnutrition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 11\/27\/1997 and 01\/15\/2014, vital status was determined for 384 patients admitted for AN at the first time in the CNU. Sociodemographic, anamnestic, and clinical data were collected. We calculated the SMR. Univariate and multivariate Cox regression analyses were performed to identify mortality predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Crude mortality rate was 11.5%. (44 deaths) and SMR 15.9 [CI 95% (11.6\u201321.4)], 5.2\u00a0years post inpatient treatment. Mortality predictors at the time of hospitalization were as follows: older age, occurrence of an in\u2010hospital suicide attempt, transfer to medical intensive care unit and the following somatic complications: frank anemia, dysnatremia, infectious and cardiac complications. Other predictors of mortality were: past or present history of discharge against medical advice, hematological comorbidities (not related to AN). A longer inpatient length of stay was a protective factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Very severely malnourished patients with AN hospitalized in a medical unit because of extremely severe somatic issues have a medium\u2010term mortality rate higher than the general population and even higher than patients in tertiary specialized ED units. This study highlights predictive factors of mortality that will help clinicians in recognizing and managing patients at risk of death.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.13261","type":"journal-article","created":{"date-parts":[[2020,11,28]],"date-time":"2020-11-28T20:02:57Z","timestamp":1606593777000},"page":"130-140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Five\u2010year mortality of severely malnourished patients with chronic anorexia nervosa admitted to a medical unit"],"prefix":"10.1111","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4502-8416","authenticated-orcid":false,"given":"Marie","family":"Guinhut","sequence":"first","affiliation":[{"name":"Paris\u2010Descartes University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7233-6991","authenticated-orcid":false,"given":"Nathalie","family":"Godart","sequence":"additional","affiliation":[{"name":"Fondation Sant\u00e9 des Etudiants de France Paris France"},{"name":"CESP INSERM UMR 1018 Paris\u2010Saclay University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9895-6654","authenticated-orcid":false,"given":"Mohamed\u2010Amine","family":"Benadjaoud","sequence":"additional","affiliation":[{"name":"Institut de Radioprotection et de S\u00fbret\u00e9 Nucl\u00e9aire Fontenay\u2010Aux\u2010Roses France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9946-4275","authenticated-orcid":false,"given":"Jean\u2010Claude","family":"Melchior","sequence":"additional","affiliation":[{"name":"Clinical Nutrition Unit Paul Brousse Hospital, APHP Villejuif France"},{"name":"Paris\u2010Saclay University France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7228-8723","authenticated-orcid":false,"given":"Mouna","family":"Hanachi","sequence":"additional","affiliation":[{"name":"Clinical Nutrition Unit Paul Brousse Hospital, APHP Villejuif France"},{"name":"Paris\u2010Saclay University France"},{"name":"UMR Micalis Institut, INRA Jouy\u2010En\u2010Josas France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_11_3_1","unstructured":"Haute Autorit\u00e9 de Sant\u00e9.Clinical practice guidelines: anorexia nervosa: management[Internet] 2010. 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