The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study
BackgroundAttention deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric disorder in children and adolescents worldwide, and children with ADHD have elevated risk of injuries. Our aim was to assess the risk of hospitalizations with injury diagnoses and their various subtypes in childre...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-10-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fped.2017.00220/full |
| _version_ | 1818521109390163968 |
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| author | Christina Lindemann Christina Lindemann Ingo Langner Tobias Banaschewski Edeltraut Garbe Edeltraut Garbe Rafael T. Mikolajczyk Rafael T. Mikolajczyk Rafael T. Mikolajczyk |
| author_facet | Christina Lindemann Christina Lindemann Ingo Langner Tobias Banaschewski Edeltraut Garbe Edeltraut Garbe Rafael T. Mikolajczyk Rafael T. Mikolajczyk Rafael T. Mikolajczyk |
| author_sort | Christina Lindemann |
| collection | DOAJ |
| description | BackgroundAttention deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric disorder in children and adolescents worldwide, and children with ADHD have elevated risk of injuries. Our aim was to assess the risk of hospitalizations with injury diagnoses and their various subtypes in children and adolescents with newly diagnosed ADHD compared to those without ADHD, as well as to study sex effects on this risk in the setting of the German health care system.MethodsThe German Pharmacoepidemiological Research Database, in which 20 million insured from four statutory health insurances in Germany are included, was used to set up a matched cohort study of 3- to 17-year-old children and adolescents with and without ADHD. We calculated age-specific incidence rates and used Cox regression to obtain hazard ratios (HRs) for hospitalizations with injury diagnoses. We used the injury mortality diagnosis matrix for classification of injuries.ResultsThe matched cohort comprised a total of 75,300 children. The age-specific incidence rates for hospitalization with injury diagnosis for males with ADHD displayed a u-shaped form with highest incidences in the in the age groups 3–6 years [26.2 per 1,000 person-years; 95% confidence interval (CI) 20.5–33.0] and 18–21 years (28.6; 22.4–36.0). Girls with ADHD were less affected in younger age-groups, but the incidence rate for 18–21 year olds was similar to boys with ADHD (26.4; 17.4–38.4). The adjusted HR for children with ADHD was 1.40 (95% CI 1.30–1.49) compared to non-affected children. With respect to nature of injury, ADHD was associated with hospitalization with injury diagnoses of the internal organs, open wounds, and contusions but not with other injuries. With respect to body regions, children with ADHD were more prone to hospitalizations with injuries of the abdomen, traumatic brain injuries, other head injuries, and system-wide injuries such as poisoning and intoxication. No significant associations were seen for the other body regions. Differences between sexes were only seen for system-wide injuries.ConclusionChildren and adolescents with ADHD are at an increased risk for hospitalizations with diagnoses of injuries compared to non-affected children. Despite differences in health-care systems, the risk increase is at a similar level in Germany as in other countries. |
| first_indexed | 2024-12-11T01:46:36Z |
| format | Article |
| id | doaj.art-06a1ea91ae934d25a058e76fa176b319 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-11T01:46:36Z |
| publishDate | 2017-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-06a1ea91ae934d25a058e76fa176b3192022-12-22T01:24:53ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602017-10-01510.3389/fped.2017.00220270113The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database StudyChristina Lindemann0Christina Lindemann1Ingo Langner2Tobias Banaschewski3Edeltraut Garbe4Edeltraut Garbe5Rafael T. Mikolajczyk6Rafael T. Mikolajczyk7Rafael T. Mikolajczyk8Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, GermanyMedical School Hannover, Hannover, GermanyDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, GermanyDepartment of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, GermanyDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, GermanyCore Scientific Area ‘Health Sciences’ at the University of Bremen, Bremen, GermanyMedical School Hannover, Hannover, GermanyESME – Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection Research, Braunschweig, GermanyInstitute for Medical Epidemiology, Biometrics and Computer Science, Martin-Luther-University Halle-Wittenberg, Halle (Saale), GermanyBackgroundAttention deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric disorder in children and adolescents worldwide, and children with ADHD have elevated risk of injuries. Our aim was to assess the risk of hospitalizations with injury diagnoses and their various subtypes in children and adolescents with newly diagnosed ADHD compared to those without ADHD, as well as to study sex effects on this risk in the setting of the German health care system.MethodsThe German Pharmacoepidemiological Research Database, in which 20 million insured from four statutory health insurances in Germany are included, was used to set up a matched cohort study of 3- to 17-year-old children and adolescents with and without ADHD. We calculated age-specific incidence rates and used Cox regression to obtain hazard ratios (HRs) for hospitalizations with injury diagnoses. We used the injury mortality diagnosis matrix for classification of injuries.ResultsThe matched cohort comprised a total of 75,300 children. The age-specific incidence rates for hospitalization with injury diagnosis for males with ADHD displayed a u-shaped form with highest incidences in the in the age groups 3–6 years [26.2 per 1,000 person-years; 95% confidence interval (CI) 20.5–33.0] and 18–21 years (28.6; 22.4–36.0). Girls with ADHD were less affected in younger age-groups, but the incidence rate for 18–21 year olds was similar to boys with ADHD (26.4; 17.4–38.4). The adjusted HR for children with ADHD was 1.40 (95% CI 1.30–1.49) compared to non-affected children. With respect to nature of injury, ADHD was associated with hospitalization with injury diagnoses of the internal organs, open wounds, and contusions but not with other injuries. With respect to body regions, children with ADHD were more prone to hospitalizations with injuries of the abdomen, traumatic brain injuries, other head injuries, and system-wide injuries such as poisoning and intoxication. No significant associations were seen for the other body regions. Differences between sexes were only seen for system-wide injuries.ConclusionChildren and adolescents with ADHD are at an increased risk for hospitalizations with diagnoses of injuries compared to non-affected children. Despite differences in health-care systems, the risk increase is at a similar level in Germany as in other countries.http://journal.frontiersin.org/article/10.3389/fped.2017.00220/fullattention deficit/hyperactivity disorderinjuriessubtype of injuriessex differencesadministrative dataclaims data |
| spellingShingle | Christina Lindemann Christina Lindemann Ingo Langner Tobias Banaschewski Edeltraut Garbe Edeltraut Garbe Rafael T. Mikolajczyk Rafael T. Mikolajczyk Rafael T. Mikolajczyk The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study Frontiers in Pediatrics attention deficit/hyperactivity disorder injuries subtype of injuries sex differences administrative data claims data |
| title | The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study |
| title_full | The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study |
| title_fullStr | The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study |
| title_full_unstemmed | The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study |
| title_short | The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study |
| title_sort | risk of hospitalizations with injury diagnoses in a matched cohort of children and adolescents with and without attention deficit hyperactivity disorder in germany a database study |
| topic | attention deficit/hyperactivity disorder injuries subtype of injuries sex differences administrative data claims data |
| url | http://journal.frontiersin.org/article/10.3389/fped.2017.00220/full |
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