Abstract
INTRODUCTION: Eating Disorders (ED) represent a significant health concern in the pediatric population due to high morbidity, prolonged hospital stays, and frequent readmissions. Scientific evidence regarding nutritional factors that may influence length of stay or risk of readmission is limited in this population. OBJECTIVES: To identify variables associated with longer hospital stays and readmission in pediatric patients with ED admitted to a reference unit in northern Spain. METHODS: A retrospective observational study was conducted following STROBE guidelines, including patients under 18 years admitted for ED at a tertiary referral hospital between 2022 and 2025. Nutritional, anthropometric, clinical, evolution-related, and treatment variables were collected. Descriptive analyses, group comparisons according to length of stay and readmission, and logistic regression models were performed to identify associated factors. RESULTS: The study included 75 patients, predominantly female (94.7%), with a mean age of 14.5 years. Twenty-eight percent of patients experienced at least one readmission during the study period. Multivariable regression identified that the use of a nasogastric tube and nutritional supplements was significantly associated with reduced length of stay. In addition, in patients with moderate to severe malnutrition, a recovery greater than 5% according to the Waterlow index was associated with a lower probability of readmission. Although anthropometric differences were observed between groups according to their need for readmission, most were not statistically significant. CONCLUSIONS: Nutritional support via nasogastric tube when indicated, the use of nutritional supplements, and a >5% recovery in the Waterlow index in patients with moderate to severe malnutrition are key factors in reducing hospital stay and readmission risk in pediatric patients with ED in our cohort. Isolated laboratory analyses and anthropometric measures showed limited predictive value in this context.