General Academic Pediatrics, Department of Pediatrics, Atrium Health, Charlotte, NC.
Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, MA.
J Dev Behav Pediatr. 2020 May;41(4):258-264. doi: 10.1097/DBP.0000000000000783.
The prevalence of obesity in autism spectrum disorder (ASD) is high, and managing obesity in children with ASD can be challenging. The study's objective was to examine developmental-behavioral pediatricians' (DBPs) coding practices for overweight/obesity in children with ASD and patient characteristics associated with coding.
We analyzed the clinical data on children with ASD with at least 1 visit at one of 3 developmental-behavioral pediatrics network sites between January 2010 and December 2011. Weight status was calculated using body mass index z-scores. For children meeting the criteria for overweight/obesity, we assessed the frequency of weight-related ICD-9 diagnosis codes at DBP visits, used multivariable logistic regression to determine characteristics associated with the presence of these codes, and examined the prevalence of weight-related codes relative to other diagnosis codes.
The sample included 4542 children, ages 2 to 19 years. 15.5% of children met the criteria for overweight, 14.7% for obesity, and 6.3% for severe obesity. Of children meeting the criteria for overweight/obesity/severe obesity, 7.5% had a weight-related code documented at their visits. Children with obesity or severe obesity and older children had higher odds of having a weight-related code. Compared with not being on medications, atypical antipsychotics use was significantly associated with increased odds of having a weight-related code. Of 3802 unique ICD-9 diagnosis codes documented at any visit during the study period, only 4% were related to weight.
Few children meeting the criteria for overweight/obesity had documented weight-related codes. Weight-related coding was more likely for children with obesity, who were older, and those taking atypical antipsychotics.
自闭症谱系障碍（ASD）患者肥胖的患病率很高，管理 ASD 儿童的肥胖症可能具有挑战性。本研究的目的是检查发育行为儿科学（DBP）对 ASD 儿童超重/肥胖的编码实践，以及与编码相关的患者特征。
我们分析了 2010 年 1 月至 2011 年 12 月期间在三个发育行为儿科网络站点之一至少就诊一次的 ASD 儿童的临床数据。体重状况通过体重指数 z 分数计算。对于符合超重/肥胖标准的儿童，我们评估了 DBP 就诊时与体重相关的 ICD-9 诊断代码的频率，使用多变量逻辑回归确定与这些代码存在相关的特征，并检查与其他诊断代码相比与体重相关的代码的患病率。
该样本包括 4542 名年龄在 2 至 19 岁的儿童。15.5%的儿童超重，14.7%肥胖，6.3%严重肥胖。在符合超重/肥胖/严重肥胖标准的儿童中，7.5%在就诊时记录了与体重相关的代码。肥胖或严重肥胖儿童和年龄较大的儿童更有可能记录与体重相关的代码。与未服用药物相比，使用非典型抗精神病药物与记录与体重相关的代码的几率增加显著相关。在研究期间任何就诊期间记录的 3802 个唯一 ICD-9 诊断代码中，只有 4%与体重有关。
符合超重/肥胖标准的儿童中，记录有与体重相关的代码的人数很少。体重相关的编码更可能出现在肥胖儿童、年龄较大的儿童和服用非典型抗精神病药物的儿童中。
