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Impact of ASD and ADHD on pediatric asthma exacerbations: a retrospective analysis of the Nationwide Inpatient Sample
Dai-Xuan Lin1,2, Ya-Ting Chang3, Yu-Chun Lo4
1Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, No. 365, Mingde Rd, Peitou Dist, Taipei City, 112303, Taiwan.
Insights
Children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) hospitalized for asthma face higher costs and increased complication risks. These neurodevelopmental conditions significantly impact asthma care, necessitating specialized management strategies.
Area of Science:
- Pediatric Pulmonology
- Neurodevelopmental Disorders
- Health Services Research
Background:
- Asthma exacerbations in children can lead to significant hospitalizations.
- The co-occurrence of neurodevelopmental disorders like autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) may influence in-hospital outcomes for pediatric asthma patients.
Purpose of the Study:
- To investigate the impact of ASD and ADHD on in-hospital outcomes among children hospitalized for asthma exacerbations.
- To compare outcomes across four groups: ASD only, ADHD only, both ASD and ADHD, and neither condition.
Main Methods:
- Retrospective analysis of the Nationwide Inpatient Sample (NIS) database (2005-2020).
- Inclusion of children aged 5-19 years admitted for asthma exacerbations.
- Utilized propensity score matching to ensure comparable groups based on baseline characteristics.
Main Results:
- Children with both ASD and ADHD incurred the highest total hospital costs, followed by those with ASD alone.
- The combined ASD and ADHD group showed significantly increased risks of overall complications (aOR=1.69), including epilepsy (aOR=3.56), pneumonia (aOR=2.00), and constipation (aOR=4.22).
- Children with ASD alone also exhibited elevated risks for epilepsy (aOR=3.79) and constipation (aOR=4.33).
Conclusions:
- Children with ASD, particularly when co-occurring with ADHD, experience greater hospital costs and heightened risks for specific complications during asthma exacerbations.
- These findings highlight a compounded effect of ASD and ADHD on pediatric asthma patients.
- Emphasizes the critical need for tailored, specialized care protocols to effectively manage these complex cases and mitigate adverse outcomes.
Background:
To explore the impact of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) on in-hospital outcomes in children hospitalized for asthma exacerbations.
Methods:
This retrospective study utilized data from the Nationwide Inpatient Sample (NIS) database between 2005 and 2020. We included children aged 5 to 19 years admitted for asthma exacerbations. Children were categorized into four groups: those with ASD only, ADHD only, both ASD and ADHD, and neither condition. Propensity score matching was used to balance baseline characteristics.
Results:
A total of 155,893 children hospitalized for asthma were identified, with 2,443 patients remaining after propensity score matching. Children with both ASD and ADHD had the highest total hospital costs, followed by those with ASD alone. Children with both ASD and ADHD had significantly increased risks of overall complications (aOR = 1.69, 95% CI: 1.27-2.26), including epilepsy (aOR = 3.56, 95% CI: 1.61-7.87), pneumonia (aOR = 2.00, 95% CI: 1.33-3.03), and constipation (aOR = 4.22, 95% CI: 1.58-11.26), compared to those without either condition. Children with ASD alone also had elevated risks for epilepsy (aOR = 3.79, 95% CI: 1.79-8.03) and constipation (aOR = 4.33, 95% CI: 1.78-10.54).
Conclusion:
In the US children hospitalized for asthma exacerbations, those with both ASD and ADHD, or ASD alone, face significantly greater costs and higher risks of specific complications, particularly epilepsy, pneumonia, and constipation. The findings suggest a compounded impact of these neurodevelopmental conditions on asthma children, emphasizing the need for specialized care to manage these patients effectively and reduce the risks.
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