Mortality in People with Eating Disorders Presenting to the Health System: Australian Population-Based Record Linkage Study.

INTRODUCTION

Most previous mortality research in eating disorders (EDs) involves individuals attending specialist treatment services. Data linkage across jurisdictional health databases at a population level improves the generalisability of findings. This study investigates mortality risk and causes of death for people with an ED across a large geographic region using administrative health datasets.

METHODS

Using linked hospital, mental health, and death records, a retrospective cohort study was conducted including individuals aged 10-59 years who received an ED diagnosis during hospital-based encounters in Australia, over a 10-year period between 2010 and 2019. A contemporary cohort of people accessing community care only was also evaluated. Mortality rates and standardised morality ratios (SMRs) compared to the general population were calculated for each state, and by sex and age groups. Cox regression models were used to assess the risk of socio-demographic characteristics on mortality.

RESULTS

Mortality in people hospitalised with an ED (N = 19,697) was more than four times higher than the general population (SMR: 4.54), and highest in people aged 30-39 years (SMR: 13.32). Men hospitalised for EDs had a higher risk of death. Mortality rates in anorexia nervosa were not higher than other ED diagnoses. Almost three-quarters of deaths were caused by suicide/self-harm or cardio/respiratory illness.

CONCLUSION

People accessing hospital care with EDs in Australia have a higher risk of premature death regardless of age, sex, or ED diagnosis. Gender and age group disparities can inform policy and resource allocation and support the development of targeted interventions.