Injuries in Children with Autism

拟议项目的长期目标是减少儿童的伤害发病率和死亡率， 自闭症谱系障碍（ASD）。具体目的是：1）检查在治疗中受伤的时间趋势， 0-20岁ASD儿童的急诊室（ED）和医院; 2）表征 根据年龄，性别， 伤害机制、意图和严重程度; 3）评估急诊室和医院治疗伤害的超额风险 与ASD有关。ASD的估计患病率继续上升。美国的监控数据 各国表示，2014年，每59名8岁儿童中就有一名符合ASD的诊断标准， 40名3至17岁的儿童有父母报告的ASD诊断。长期以来，伤害一直被认为是一种主要的 美国儿童发病和死亡的原因，导致大约18，000人死亡， 超过900万次急诊就诊和20多万次住院治疗， 每年超过20岁。最近的研究表明，患有ASD的儿童可能在特殊的 受伤死亡率和某些类型的受伤发病率的风险增加，可能是由于社会， 认知和行为功能以及注意力缺陷多动等常见共病 精神障碍和智力残疾。关于ASD儿童损伤的研究不足，而且往往受到以下因素的限制： 小样本量和自我报告的数据。基于我们最近对ASD儿童伤害死亡率的研究， 和伤害的学龄前自闭症儿童，拟议的项目旨在缩小一个重要的研究差距， 通过检查急诊室和医院治疗的时间趋势、流行病学模式和过度风险， 根据全国代表性样本，21岁以下的ASD儿童。我们将使用 2009-2019年全国急诊科样本和三年期儿童住院患者数据库 从1997年到2019年，为诊断为ASD的儿科艾德患者（n = 300，000）和 诊断为ASD的儿科住院患者（n = 70，000）。我们将研究时间趋势，流行病学 ASD儿童在急诊室和医院接受治疗的伤害模式和过度风险（根据伤害） 机制、意图、严重程度、人口统计学特征、合并症和地理区域 与一般儿科患者人群相比。拟议项目的结果将告知预防性 战略和促进有效的干预措施的发展，以减少ASD儿童的伤害。

The long-term objective of the proposed project is to reduce injury morbidity and mortality in children with autism spectrum disorders (ASD). The specific aims are to: 1) examine the time trends of injuries treated in emergency departments (EDs) and hospitals among children with ASD aged 0–20 years; 2) characterize the epidemiologic patterns of injuries treated in EDs and hospitals among children with ASD according to age, sex, injury mechanism, intent and severity; and 3) assess the excess risks of injuries treated in EDs and hospitals associated with ASD. The estimated prevalence of ASD continues to rise. Surveillance data in the United States indicate that one in 59 children aged 8 years in 2014 met the diagnostic criteria for ASD and that one in 40 children aged 3 to 17 years had parent-reported ASD diagnosis. Injury has long been recognized as a major cause of morbidity and mortality in children in the United States, resulting in approximately 18,000 deaths with over 9 million emergency department visits and more than 200,000 hospitalizations among children younger than 20 years of age annually. Recent studies indicate that children with ASD may be at exceptionally heightened risk of injury mortality and certain types of injury morbidity, likely due to impairments in social, cognitive and behavioral functioning and common comorbid conditions such as attention deficit hyperactivity disorder and intellectual disability. Research on injury in children with ASD is inadequate and often limited by small sample sizes and self-reported data. Building on our recent work on injury mortality in children with ASD and injuries in preschool age children with ASD, the proposed project aims to close an important research gap by examining the time trends, epidemiologic patterns and excess risks of injuries treated in EDs and hospitals in children with ASD under 21 years of age based on nationally representative samples. We will use the Nationwide Emergency Department Sample for years 2009–2019 and the triennial Kids’ Inpatient Database from 1997 to 2019 to create datasets for pediatric ED patients with a diagnosis of ASD (n ≈ 300,000) and for pediatric inpatients with a diagnosis of ASD (n ≈ 70,000). We will examine the time trends, epidemiologic patterns and excess risks of injuries treated in EDs and hospitals among children with ASD according to injury mechanism, intent, severity, demographic characteristics, comorbid conditions, and geographic regions compared to the general pediatric patient population. Results from the proposed project will inform preventive strategies and facilitate the development of effective interventions to reduce injuries in children with ASD.