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A groundbreaking study published in The Lancet Psychiatry has revealed a significant association between electrolyte abnormalities and increased mortality risk among individuals with eating disorders. The research, led by experts from ICES and The Ottawa Hospital, highlights that 32% of individuals with an eating disorder exhibit abnormal electrolyte levels, which correlate with a heightened risk of death from any cause.
Study Overview and Findings
This extensive, population-based study is one of the first to identify electrolyte abnormalities as a crucial risk factor for mortality and adverse health outcomes in eating disorder patients. Researchers analyzed health records from over 6,000 individuals aged 13 and older who had been diagnosed with an eating disorder and had undergone electrolyte testing within a year of diagnosis. The data, spanning from 2008 to 2019, was sourced from hospitalization and emergency department records in Ontario, Canada.
The study uncovered that electrolyte abnormalities were notably prevalent among participants, with 32% of those with an eating disorder showing such abnormalities. These disturbances in electrolytes, such as potassium and sodium, can significantly impact bodily functions and are commonly seen in individuals with eating disorders due to purging, laxative use, and dehydration.
Key Results and Implications
The analysis revealed that individuals with electrolyte abnormalities had a higher mortality rate compared to those without these abnormalities. Specifically, 16% of those with an electrolyte disorder died, compared to just 6% of those without such disturbances. Electrolyte abnormalities were also linked to an increased risk of hospitalization and severe health conditions, including chronic kidney disease, bone fractures, bowel obstruction, and acute kidney injury. However, no significant association was found with infection or heart disease events.
Dr. Marco Solmi, the lead author of the study, emphasized the need for explicit inclusion of electrolyte abnormalities in the criteria used to assess the severity of eating disorders. “These findings underscore the importance of testing for electrolyte levels in individuals with eating disorders and taking appropriate actions based on the results to potentially reduce the risk of death and other severe outcomes,” said Dr. Solmi, who is the Medical Director of the Regional Eating Disorder Program at The Ottawa Hospital and Director of Research at the University of Ottawa’s Psychiatry Department.
Expert Insights
Co-lead author Dr. Nicholas Fabiano, a psychiatry resident at The Ottawa Hospital and the University of Ottawa, highlighted the importance of this research in shaping clinical practices. “Our findings indicate a crucial role for electrolyte testing and subsequent interventions in managing eating disorders. This can significantly impact patient health outcomes and potentially lower mortality rates,” he stated.
Senior author Dr. Gregory Hundemer, adjunct scientist at ICES and nephrologist at The Ottawa Hospital, stressed the broader implications for patient education and care. “Eating disorders can often be underestimated in terms of their severity and long-term health implications. This study shows that electrolyte disturbances are serious and can have major repercussions for patient health,” he explained.
Recommendations for Clinical Practice
The researchers propose that these findings could lead to a re-evaluation of how clinicians assess the severity of eating disorders. Current assessments primarily focus on body mass index and the frequency of disordered behaviors, but incorporating electrolyte abnormalities into this framework may enhance the accuracy of severity assessments and improve patient care.
Overall, this study presents a critical opportunity to refine clinical practices and enhance patient outcomes for those suffering from eating disorders. By integrating electrolyte testing and addressing these abnormalities, healthcare providers can better manage the health risks associated with these complex conditions.
Source: Institute for Clinical Evaluative Sciences
Journal Reference: Solmi, M., et al. (2024) Adverse outcomes and mortality in individuals with eating disorder-related electrolyte abnormalities in Ontario, Canada: a population-based cohort study. The Lancet Psychiatry. doi.org/10.1016/S2215-0366(24)00244-X.
