Abstract
Background
Individuals with eating disorders (EDs) have a high mortality risk. Few population-based studies have estimated mortality risk in EDs other than anorexia nervosa.
Aims
To investigate all-cause mortality within a population-based cohort of individuals who received hospital-based care for any ED (anorexia nervosa, bulimia nervosa or ED not otherwise specified) in Ontario, Canada.
Methods
We conducted a retrospective-cohort study of 19,041 individuals with an ED from January 1, 1990, to December 31, 2013 using administrative healthcare data. The outcome of interest was death. Excess mortality was assessed using standardized mortality ratios (SMRs) and potential years of life lost (PYLL). Cox proportional hazards regression models were used to examine socio-demographic and medical comorbidities associated with greater mortality risk.
Results
The ED cohort had 17,108 females (89.9%) and 1,933 males (10.1%). The all-cause mortality for the entire ED cohort was five times higher than expected compared to the Ontario population (SMR = 5.06; 95% CI:4.82-5.30). SMRs were higher for males (SMR=7.24; 95% CI: 6.58- 7.96) relative to females (SMR=4.59; 95% CI: 4.34-4.85), overall and in all age groups in the cohort. For both sexes, the ED cohort PYLL was more than 6 times higher than the expected PYLL in the Ontario population.
Conclusions and Relevance
Patients with EDs experience five to seven times higher mortality rates compared to the overall population. There is an urgent need to understand the mortality risk factors to improve health outcomes among individuals with eating disorders.
Individuals with eating disorders (EDs) have a high mortality risk. Few population-based studies have estimated mortality risk in EDs other than anorexia nervosa.
Aims
To investigate all-cause mortality within a population-based cohort of individuals who received hospital-based care for any ED (anorexia nervosa, bulimia nervosa or ED not otherwise specified) in Ontario, Canada.
Methods
We conducted a retrospective-cohort study of 19,041 individuals with an ED from January 1, 1990, to December 31, 2013 using administrative healthcare data. The outcome of interest was death. Excess mortality was assessed using standardized mortality ratios (SMRs) and potential years of life lost (PYLL). Cox proportional hazards regression models were used to examine socio-demographic and medical comorbidities associated with greater mortality risk.
Results
The ED cohort had 17,108 females (89.9%) and 1,933 males (10.1%). The all-cause mortality for the entire ED cohort was five times higher than expected compared to the Ontario population (SMR = 5.06; 95% CI:4.82-5.30). SMRs were higher for males (SMR=7.24; 95% CI: 6.58- 7.96) relative to females (SMR=4.59; 95% CI: 4.34-4.85), overall and in all age groups in the cohort. For both sexes, the ED cohort PYLL was more than 6 times higher than the expected PYLL in the Ontario population.
Conclusions and Relevance
Patients with EDs experience five to seven times higher mortality rates compared to the overall population. There is an urgent need to understand the mortality risk factors to improve health outcomes among individuals with eating disorders.
| Original language | English |
|---|---|
| Pages (from-to) | 1-7 |
| Number of pages | 7 |
| Journal | British Journal of Psychiatry |
| Early online date | 29 Oct 2020 |
| DOIs | |
| Publication status | E-pub ahead of print - 29 Oct 2020 |
Bibliographical note
© The Author(s), 2020. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.Keywords
- Anorexia Nervosa
- Bulimia nervosa
- Eating Disorders
- Mortality
- Epidemiology
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