Mortality in Persons With Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis.
Mortality in Persons With Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis.
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DOI：
10.1001/jamapediatrics.2021.6401
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发表时间：
2022-04-01
期刊：
影响因子：
26.1
通讯作者：
Tabarés-Seisdedos R
中科院分区：
文献类型：
--
作者：
Catalá-López F;Hutton B;Page MJ;Driver JA;Ridao M;Alonso-Arroyo A;Valencia A;Macías Saint-Gerons D;Tabarés-Seisdedos R
这项系统性综述和荟萃分析评估了自闭症谱系障碍或注意力缺陷/多动障碍患者及其一级亲属的全因死亡率和特定原因死亡率的风险。与普通人群相比，自闭症谱系障碍（ASD）或注意力缺陷多动障碍（ADHD）患者的死亡风险是否更高？在这项对27项研究的系统回顾和荟萃分析中，ASD或ADHD患者的死亡率高于普通人群。当检查死亡原因时，ASD和ADHD与非自然原因（例如，受伤，中毒和其他）导致的死亡率较高相关，只有ASD患者的自然死亡原因（例如，神经系统，呼吸系统和癌症）的死亡风险增加。患有ASD或ADHD可能与更高的死亡风险相关。自闭症谱系障碍（ASD）和注意力缺陷/多动障碍（ADHD）是儿童期发病的疾病，可能持续到成年。一些研究表明，它们可能与死亡风险增加有关;然而，结果并不一致。评估ASD或ADHD患者及其一级亲属的死亡风险。检索MEDLINE、Embase、Scopus、Web of Science和PsycINFO（从开始到2021年4月1日发表），并通过检索检索到的文章的参考文献列表进行补充。纳入了队列和病例对照研究，这些研究报告了ASD或ADHD患者和/或其一级亲属与普通人群或非ASD/ADHD患者的死亡率比（RR）。筛选、数据提取和质量评估由至少2名研究人员独立进行。使用随机效应模型对个体研究进行荟萃分析并评估异质性（I2）。与ASD或ADHD相关的全因死亡率次要结局是病因特异性死亡率。纳入了27项研究，共计642260人。ASD患者的全因死亡率较高（154 238例受试者; 12项研究; RR，2.37; 95% CI，1.97-2.85; I2，89%;中等置信度）和ADHD患者（396 488例受试者; 8项研究; RR，2.13; 95% CI，1.13-4.02; I2，98%;低置信度）。在ASD患者中，自然原因死亡（4项研究; RR，3.80; 95% CI，2.06-7.01; I2，96%;低置信度）和非自然原因死亡增加（6项研究; RR，2.50; 95% CI，1.49-4.18; I2，95%;低置信度）。在ADHD患者中，自然原因导致的死亡没有显著增加（4项研究; RR，1.62; 95%CI，0.89-2.96; I2，88%;低置信度），但非自然原因导致的死亡高于预期（10项研究; RR，2.81; 95%CI，1.73-4.55; I2，92%;低置信度）。这项系统性综述和荟萃分析发现，ASD和ADHD与死亡风险显著增加相关。了解这些关联的机制可能会导致有针对性的战略，以防止高风险群体中可避免的死亡。研究之间的实质异质性应进一步探讨。
This systematic review and meta-analysis evaluates the risk of both all-cause and cause-specific mortality among persons with autism spectrum disorder or attention-deficit/hyperactivity disorder and their first-degree relatives. Are persons with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) at a higher risk of dying compared with the general population? In this systematic review and meta-analysis of 27 studies, persons with ASD or ADHD had higher mortality rates than the general population. When causes of death were examined, ASD and ADHD were associated with higher mortality due to unnatural causes (eg, injury, poisoning, and other), and only persons with ASD had an increased risk of mortality from natural causes of death (eg, neurologic, respiratory system, and cancer). Having ASD or ADHD may be associated with higher mortality risks. Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are childhood-onset disorders that may persist into adulthood. Several studies have suggested that they may be associated with an increased risk of mortality; however, the results are inconsistent. To assess the risk of mortality among persons with ASD or ADHD and their first-degree relatives. A search of MEDLINE, Embase, Scopus, Web of Science, and PsycINFO (published from inception to April 1, 2021) was supplemented by searching reference lists of the retrieved articles. Cohort and case-control studies that reported mortality rate ratios (RRs) in persons with ASD or ADHD and/or their first-degree relatives compared with the general population or those without ASD/ADHD were included. Screening, data extraction, and quality assessment were performed by at least 2 researchers independently. A random-effects model was used to meta-analyze individual studies and assessed heterogeneity (I2). All-cause mortality in association with ASD or ADHD. Secondary outcome was cause-specific mortality. Twenty-seven studies were included, with a total of 642 260 individuals. All-cause mortality was found to be higher for persons with ASD (154 238 participants; 12 studies; RR, 2.37; 95% CI, 1.97-2.85; I2, 89%; moderate confidence) and persons with ADHD (396 488 participants; 8 studies; RR, 2.13; 95% CI, 1.13-4.02; I2, 98%; low confidence) than for the general population. Among persons with ASD, deaths from natural causes (4 studies; RR, 3.80; 95% CI, 2.06-7.01; I2, 96%; low confidence) and deaths from unnatural causes were increased (6 studies; RR, 2.50; 95% CI, 1.49-4.18; I2, 95%; low confidence). Among persons with ADHD, deaths from natural causes were not significantly increased (4 studies; RR, 1.62; 95% CI, 0.89-2.96; I2, 88%; low confidence), but deaths from unnatural causes were higher than expected (10 studies; RR, 2.81; 95% CI, 1.73-4.55; I2, 92%; low confidence). This systematic review and meta-analysis found that ASD and ADHD are associated with a significantly increased risk of mortality. Understanding the mechanisms of these associations may lead to targeted strategies to prevent avoidable deaths in high-risk groups. The substantial heterogeneity between studies should be explored further.
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影响因子：
4.7
作者：
Hwang, Ye In (Jane);Srasuebkul, Preeyaporn;Trollor, Julian N.
通讯作者：
Trollor, Julian N.
影响因子：
8
作者：
Barbaresi, William J.;Colligan, Robert C.;Katusic, Slavica K.
通讯作者：
Katusic, Slavica K.
影响因子：
5.2
作者：
Akobirshoev, Ilhom;Mitra, Monika;Lauer, Emily
通讯作者：
Lauer, Emily
影响因子：
3.7
作者：
Fairthorne, Jenny;Hammond, Geoff;Leonard, Helen
通讯作者：
Leonard, Helen
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N