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PEDIATRICS Vol. 102 No. 6 December 1998, pp. 1415-1421

Injuries to Children With Attention Deficit Hyperactivity Disorder

Received Oct 23, 1997; accepted Jun 4, 1998.

Carla DiScala*, Ilana LescohierDagger , Martha Barthel§, and Guohua Liparallel

From the * Department of Physical Medicine and Rehabilitation, Tufts University School of Medicine, Boston, Massachusetts; the Dagger  Harvard School of Public Health, Boston, Massachusetts; the § Children's Memorial Hospital, Chicago, Illinois; and the parallel  Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.

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.  Key words:  injuries, psychosocial, risk, attention deficit hyperactivity disorder, disability.




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