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)。具体的目标是：1)检查受伤治疗的时间趋势 急诊科和医院在0-20岁的自闭症儿童中的应用；2) 自闭症儿童在急诊室和医院接受伤害治疗的流行病学模式按年龄、性别、 伤害机制、意图和严重程度；以及3)评估在急诊室和医院治疗的伤害的额外风险 与ASD相关。据估计，自闭症的患病率继续上升。美国的监控数据 各州表示，2014年，每59名8岁的儿童中就有一人符合自闭症的诊断标准，而 40名3至17岁的儿童被父母报告为ASD。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原因，造成约18,000人死于 儿童急诊科就诊900多万人次，住院20多万人次 每年超过20岁。最近的研究表明，患有自闭症的儿童可能处于异常的状态 伤害死亡率和某些类型伤害发病率的高风险，可能是由于社会、 认知和行为功能以及常见的共病情况，如注意缺陷多动 精神障碍和智力残疾。对自闭症儿童损伤的研究不够充分，而且往往受到 样本量小，自我报告的数据。以我们最近关于自闭症儿童伤害死亡率的工作为基础 对于患有自闭症的学龄前儿童的伤害，拟议的项目旨在弥合一项重要的研究差距 通过检查急诊室和医院治疗伤害的时间趋势、流行病学模式和额外风险 根据具有全国代表性的样本，对21岁以下的自闭症儿童进行调查。我们将使用 2009-2019年全国急诊科样本和三年一度的儿童住院数据库 从1997年到2019年，为被诊断为自闭症的儿科ED患者创建数据集(n≈300,000)和 被诊断为自闭症的儿科住院患者(n≈70,000)。我们将检查时间趋势，流行病学 根据伤害在自闭症儿童中急诊室和医院治疗的伤害模式和额外风险 机制、意图、严重性、人口特征、并存状况和地理区域 与普通儿科患者群体相比。拟议项目的结果将为预防 战略和促进制定有效的干预措施，以减少自闭症儿童的伤害。

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.