The presence of medical complications may or may not
lead to hospital admission. As noted earlier, significant
contextual factors, availability and regional treatment philosophies
influence admission decisions [111] both within
and between countries. When acute medical presentations
occur, particular care is needed to avoid the refeeding syndrome
and other treatment-related complications. Medical
symptoms may be alarming and prompt consideration of
urgent steps, but cautious use of otherwise considered
routine interventions (for example, intravenous fluids) is
required in order to avoid catastrophic consequences
[112]. A small number of patients will require an explicit
medical admission.