Weight Recovery in an Outpatient Medical Eating Disorders Clinic: A Retrospective Review.

BACKGROUND: The purpose of this study was to identify rates of weight recovery among adolescents and young adults with restrictive eating disorders (RED) as part of a quality improvement assessment in an Adolescent Medicine outpatient clinic in Rhode Island. METHODS: A retrospective chart review was completed on 94 randomly selected patients ages 10-21 years old. Demographics, descriptors, time to weight recovery, and participation in other care were recorded. RESULTS: The average age of participants was 15 years; most were female, cis-gender, White, had private insurance, and had one or more co-morbid psychiatric diagnosis. At intake, 81% were <95% treatment goal weight (TGW), with 27% at <80% TGW. Among participants who started at <95% of TGW, 51% achieved ≥95% of TGW; participants who engaged in a higher level of care were more successful. CONCLUSIONS: This study identifies outcomes and highlights the challenge of weight recovery among patients with RED, even when managed by an expert clinical team.

Readmissions among patients with COVID-19.

BACKGROUND: Hospital readmissions are associated with poor patient outcomes and increased health resource utilisation. The need to study readmission patterns is even bigger during a pandemic because the burden is further stretching the healthcare system. METHODS: We reviewed the initial hospitalisation and subsequent readmission for 19 patients with confirmed COVID-19 in the largest statewide hospital network in Rhode Island, US, from March 1st through April 19th, 2020. We also compared the characteristics and clinical outcomes between readmitted and non-readmitted patients. RESULTS: Of the 339 hospitalised patients with COVID-19, 279 discharged alive. Among them, 19/279 were readmitted (6.8%) after a median of 5 days. There was a significantly higher rate of hypertension, diabetes, chronic pulmonary disease, liver disease, cancer and substance abuse among the readmitted compared with non-readmitted patients. The most common reasons of readmissions happening within 12 days from discharge included respiratory distress and thrombotic episodes, while those happening at a later time included psychiatric illness exacerbations and falls. The length of stay during readmission was longer than during index admission and more demanding on healthcare resources. CONCLUSION: Among hospitalised patients with COVID-19, those readmitted had a higher burden of comorbidities than the non-readmitted. Within the first 12 days from discharge, readmission reasons were more likely to be associated with COVID-19, while those happening later were related to other reasons. Readmissions characterisation may help in defining optimal timing for patient discharge and ensuring safe care transition.