Prevalence of Traumatic Brain Injury in Children with Attention-Deficit/Hyperactivity Disorder: a Cross-Sectional Study

摘要

Introduction and Objective: Attention-deficit/hyperactivity disorder (ADHD) affects 11% of school-age children in the United States. It is reported that 4.5% of children with ADHD later sustain a non-fatal injury, compared to 2.5% of children without ADHD. By identifying groups of children at higher risk of traumatic brain injury (TBI), providers can more effectively educate patients and their families regarding preventative measures. This study analyzed whether children 2 to 17 years of age diagnosed with ADHD have a higher prevalence of TBI as compared to similar children without ADHD. We hypothesized that children with pre-existing ADHD would be more likely to sustain TBI. Methods: We used a population-based cross-sectional study of children 2-17 years old, who participated in the 2011-2012 National Survey of Children’s Health (NSCH). We excluded children with intellectual disabilities, mental retardation, cerebral palsy, epilepsy or seizure disorder, hearing impairments, or uncorrectable vision problems. NSCH responses were used to determine the presence or absence of ADHD and of TBI. We developed contingency tables and calculated adjusted and unadjusted odds ratios using logistic regression analysis, addressing potential confounding by age, gender, race/ethnicity, socioeconomic status, health insurance status, participation in sports, and comorbidities. Results: Of the 85,637 children ages 2 to 17 initially surveyed, 6,198 were excluded based on co-existing neurodevelopmental disorders, for a total of 79,439 children. Both bivariate and adjusted analyses showed that ADHD is associated with an increased risk of TBI (OR 2.5; 95% CI 2.0-3.2; p