P403 A five year review of ‘really sick inpatients with anorexia nervosa’ at university hospital limerick

Background The Junior MARSIPAN (Management of Really SIck Inpatients with Anorexia Nervosa) guideline provides paediatricians with a framework for managing anorexia nervosa in the inpatient setting. Objectives Our aim was to retrospectively review patients in our catchment area with a confirmed diagnosis of anorexia nervosa who required inpatient hospitalisation for management of their eating disorder. We wanted to compare the care provided at our hospital to the recommendations set out in the guidelines. Methodology We collected data on demographics, morbidity on presentation, number and length of hospital stays, psychosocial stressors and outcomes to date in our cohort over the 5 year period of 2014–2018. Results We had a total of 10 ‘really sick inpatients with anorexia nervosa’ at University Hospital Limerick during this period of 5 years. There were 7 females and 3 males. Our patients ranged in age from 10 years to 18 years. The average age of first presentation for our patient cohort was 11.75 years. The longest number of days spent in hospital by a patient in one year was 124 days. Stressors at home were a background feature in 75% of our patients. There was no associated mortality to date in our cohort. Outcomes to date are mostly good although one patient developed obesity and another is on multiple medications for psychiatric comorbidities. Conclusion There is certainly a link between a greater severity of illness and comorbidities and longer inpatient hospital stays. These cases demonstrate the complexity and variety of presentations to a regional unit. There are significant challenges, in the Irish setting, in providing care to these patients. Resource limitation represents a significant factor in patient outcomes.