Eating disorder hospitalizations and risk of death in young adults in the United States: insights from the National Inpatient Sample

Globally, research shows increasing rates of eating disorders as well as a changing demographic profile of people with eating disorders. Few studies have examined recent nationally representative data on young adult patients with eating disorders in the United States and whether hospitalizations differ by race, ethnicity, sex, and primary payer status. This study characterized the risk of death for young adult hospitalizations with eating disorder diagnoses by race, ethnicity, sex, length of stay, and primary payer. This study is a retrospective national population-based analysis of the Healthcare Cost and Utilization Project’s (HCUP) National Inpatient Sample (NIS) data from 2016 to 2019. Hospitalizations of young adults ages 18–30 years of age with eating disorder diagnoses were extracted from the nationally representative National Inpatient Sample. The study’s primary variable, eating disorders, was characterized overall. Additional covariates included sex, race and ethnicity, age, primary payer, death, and length of stay. Bivariate analyses, Chi-squared tests and Fisher’s exact test were used to examine the risk of death by race, ethnicity, sex, length of stay and primary payer. For the 9,626 hospitalizations with an eating disorder diagnosis for young adults ages 18–30 years between 2016 and 2019, 24 resulted in death during hospitalization (0.2%). This study’s results revealed that males having a higher risk of death during hospitalization (29.2%) compared to females with an eating disorder diagnosis (12.2%). In addition, hospitalizations resulting in death had significantly longer mean stays (12.83 days) compared to those who did not die (7.43 days). This research study identified and characterized hospitalizations for patients with eating disorders ages 18–30 years and examined the risk of death for eating disorder hospitalizations. Overall, this study provided evidence of diversity in eating disorder presentation in the United States and possible disparities in hospitalizations and risk of death for young adult males with eating disorders. Results may help guide additional research efforts into understanding the mechanisms that may place some populations at disproportionate risk of death, which subsequently could lead to refined and tailored eating disorder prevention and treatment approaches. Few studies have examined recent nationally representative data on young adult patients with eating disorders in the United States and whether hospitalizations differ by race, ethnicity, sex, and primary payer status. International studies outside of the United States show a changing demographic profile of patients with eating disorders. Given the high mortality rate for patients with eating disorders, understanding who is at risk for death during eating disorder related hospitalization is of great importance. This study examines the associations between sex, race and ethnicity, age, primary payer, death, length of stay, and risk of death in hospitalizations of young adults ages 18–30 years of age. Results showed that male patients hospitalized with eating disorders had a higher risk of death compared to female patients hospitalized with eating disorders. Results may help guide additional research efforts into understanding the mechanisms, including societal stereotyping, that may place some populations at disproportionate risk of death, which subsequently could lead to refined and tailored eating disorder prevention and treatment approaches.