Injuries to children with attention deficit hyperactivity disorder
Injuries to children with attention deficit hyperactivity disorder
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DOI：
10.1542/peds.102.6.1415
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发表时间：
1998-12-01
期刊：
影响因子：
8
通讯作者：
Li, GH
中科院分区：
文献类型：
--
作者：
DiScala, C;Lescohier, I;Li, GH
目标.目的：研究外伤前注意缺陷多动障碍（ADHD）儿童与外伤前无注意缺陷多动障碍（NO）儿童在入院时的损伤情况。对5 ~ 14岁的ADHD患者（n = 240）和NO患者（n = 21902）进行比较分析（不包括死亡）。人口统计学、损伤特征、住院时间、入住重症监护室、手术干预、残疾和出院处置。数据来源。对1988年10月至1996年4月参加国家儿科创伤登记的70多家医院提交的病历进行回顾性分析。ADHD儿童发生意外伤害的危险因素有：男孩（87.9%vs66.5%）、行人（27.5%vs18.3%）、骑自行车者（17.1%vs13.8%）和自身伤害（1.3%vs0.1%）。他们更有可能遭受多个身体部位的伤害（57.1%对43%），头部受伤（53%对41%），以及根据损伤严重程度评分（12.5%对5.4%）和格拉斯哥昏迷评分（7.5%对3.4%）测量的严重伤害。ADHD的平均住院时间为6.2天，而NO组为5.4天。在两组中，40%的儿童接受了手术，但ADHD儿童更频繁地进入重症监护室（37.1%对24.1%）。这种伤害导致53%的ADHD儿童残疾，而NO儿童的残疾率为48%。患有任何残疾的ADHD儿童出院到康复/延长护理的可能性是NO儿童的两倍。患有ADHD的受伤儿童比没有ADHD的儿童更容易受到严重伤害。需要进行更多的研究，以确定专门针对这一人群的预防工作。
Objectives. To determine differences between hospital admitted injuries to children with preinjury attention deficit hyperactivity disorder (ADHD) and injuries to those with no preinjury conditions (NO).Design. Comparative analysis, excluding fatalities, of ADHD patients (n = 240) to NO patients (n = 21 902), 5 through 14 years of age.Outcome Measures. Demographics, injury characteristics, length of stay, admission to the intensive care unit, surgical intervention, disability, and disposition at discharge.Data Source. Retrospective review of charts submitted by more than 70 hospitals participating in the National Pediatric Trauma Registry between October 1988 and April 1996.Results. Compared with the NO children, the children with ADHD were more likely to be boys (87.9% vs 66.5%), to be injured as pedestrians (27.5% vs 18.3%) or bicyclists (17.1% vs 13.8%), and to inflict injury to themselves (1.3% vs 0.1%). They were more likely to sustain injuries to multiple body regions (57.1% vs 43%), to sustain head injuries (53% vs 41%), and to be severely injured as measured by the Injury Severity Score (12.5% vs 5.4%) and the Glasgow Coma Scale (7.5% vs 3.4%). The ADHD mean length of stay was 6.2 days versus 5.4 in the NO group. In both groups, 40% had surgery, but the ADHD children were admitted more frequently to the intensive care unit (37.1% vs 24.1%). The injury led to disability in 53% of the children with ADHD vs 48% of the NO children. Children with ADHD with any disability were twice as likely to be discharged to rehabilitation/ extended care than were the NO children.Conclusions. Injured children with ADHD are more likely to sustain severe injuries than are children without ADHD. More research is needed to identify prevention efforts specifically targeted at this population.