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Injury among children and young people with and without attention deficit-hyperactivity disorder in the community: the risk of fractures, thermal injuries and poisonings

Prasad, Vibhore; West, Joe; Sayal, Kapil; Kendrick, Denise

Injury among children and young people with and without attention deficit-hyperactivity disorder in the community: the risk of fractures, thermal injuries and poisonings Thumbnail


Authors

Vibhore Prasad

JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology

KAPIL SAYAL kapil.sayal@nottingham.ac.uk
Professor of Child and Adolescent Psychiatry

DENISE KENDRICK DENISE.KENDRICK@NOTTINGHAM.AC.UK
Professor of Primary Care Research



Abstract

Background: Injuries commonly cause morbidity and mortality in children and young people (CYP). Attention deficit-hyperactivity disorder (ADHD) is the commonest neurobehavioural disorder in CYP and is associated with increased injury risk. However, large, population-based estimates of the risk of specific injuries are lacking. We aimed to provide estimates of the risk of fractures, thermal injuries and poisonings in CYP with and without ADHD.
Methods: In this population-based cohort study we used primary and secondary care medical records from England from the Clinical Practice Research Datalink (CPRD). There were 15,126 CYP with ADHD frequency-matched to 263,724 without, aged 3-17 years at diagnosis. The risk of: (i) fractures (ii) thermal injuries, and (iii) poisonings in CYP with ADHD was compared to those without.
Results: The absolute rate of injury per thousand person years at risk in CYP with vs. without ADHD was: fracture 28.9 (95%CI 27.5 to 30.3) vs. 18.7 (95%CI 18.5 to 19.0); long bone fracture 17.7 (95%CI 16.7 to 18.8) vs. 11.8 (95%CI 11.6 to 12.0); thermal injuries 4.4 (95%CI 3.9 to 4.9) vs. 2.2 (95%CI 2.1 to 2.3); poisonings 6.3 (95%CI 5.7 to 6.9) vs. 1.9 (95%CI 1.9 to 2.0). Adjusting for age, sex, geographical region, deprivation and calendar year, CYP with ADHD had: 25% increase in risk of fracture, (hazard ratio, HR=1.25 (95% CI 1.19 to 1.31)); 21% increase in risk of long bone fracture, (HR=1.21 (95% CI 1.13 to 1.28)); double the risk of thermal injury (HR=2.00 (95% CI 1.76 to 2.27) and almost four times the risk of poisoning (HR=3.72 (95% CI 3.32 to 4.17).
Conclusions: CYP with ADHD are at greater risk of fracture, thermal injury and poisoning compared to those without. Paediatricians and healthcare professionals should provide injury prevention advice at diagnosis and reviews.

Citation

Prasad, V., West, J., Sayal, K., & Kendrick, D. (2018). Injury among children and young people with and without attention deficit-hyperactivity disorder in the community: the risk of fractures, thermal injuries and poisonings. Child: Care, Health and Development, 44(6), 871-878. https://doi.org/10.1111/cch.12591

Journal Article Type Article
Acceptance Date Jun 16, 2018
Online Publication Date Jul 24, 2018
Publication Date Nov 30, 2018
Deposit Date Jul 5, 2018
Publicly Available Date Mar 29, 2024
Journal Child: Care, Health and Development
Print ISSN 0305-1862
Electronic ISSN 0305-1862
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 44
Issue 6
Pages 871-878
DOI https://doi.org/10.1111/cch.12591
Keywords Attention Deficit-Hyperactivity Disorder (ADHD); injury; fracture; thermal injury; poisoning
Public URL https://nottingham-repository.worktribe.com/output/939136
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1111/cch.12591
Additional Information This is the peer reviewed version of the following article: Prasad V, West J, Sayal K, Kendrick D. Injury among children and young people with and without attention deficit-hyperactivity disorder in the community: the risk of fractures, thermal injuries and poisonings. Child: Care, Health and Development 2018: Published Online First: 24 July 2018 doi: 10.1111/cch.12591 which has been published in final form at https://doi.org/10.1111/cch.12591 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.