Predicting Drop-out Among Underweight Hospitalized Patients

Researchers at Johns Hopkins School of Medicine, Baltimore, and Case Western Reserve University, Cleveland, have identified several factors that seem to lead underweight eating disorders patients to leave inpatient treatment early.

At the Eating Disorders Research Society meeting held October 25-27, in Pittsburgh, Janelle Coughlin, PhD and colleagues reported that in their study of 213 underweight hospitalized patients with eating disorders, age, bone density (BD), and factors related to the duration of the illness were more relevant predictors of treatment completion than were behavioral subtype or readiness and willingness to enter treatment.

They defined drop-outs as those who were 4 lb or more below their target weights at discharge. Those defined as treatment completers were within 4 lb of their target weights at discharge. Those who dropped out of treatment were further defined as early dropouts (those who left treatment before transition from inpatient to partial hospitalization) or late dropouts (those who left after being stepped down to partial hospitalization).

Factors that led to premature discharge

Factors that were significantly linked to premature discharge were: lower body mass index (BMI, kg/m2) on admission, lower BD, and adult status. An identical regression, including premature dropouts only, was then performed with drop-out status (early or late) as a criterion variable. Higher admission BD, a greater number of past admissions, a longer history of dieting, and adult status were also significant predictors of patients who dropped out of treatment early.