Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA.
Popul Health Manag. 2022 Jun;25(3):335-342. doi: 10.1089/pop.2021.0218. Epub 2021 Nov 15.
Emerging evidence on the disproportionate impact of COVID-19 on people with intellectual and developmental disabilities (IDD) points to the underlying risk and burden of infectious diseases (IDs) in this population. The objective of this study was to examine the risk of ID-related emergency department (ED) visits, subsequent hospitalizations, and hospital-based mortality during ID-related visits among adults with IDD compared to those without IDD. The authors conducted a retrospective study using data from the 2016 Nationwide Emergency Department Sample. The sample included 94,928 adults with IDD identified using ICD-10-CM codes, and age- and sex-matched 284,763 non-IDD adults in a 1:3 case-control ratio. A Poisson regression model was used to compare the risk of ID-related ED visits, subsequent hospitalizations, and hospital-based mortality during ID-related visits between adults with and without IDD. Covariates included sociodemographic and hospital characteristics. Results showed that adults with IDD are at a higher risk for ID-related ED visits, subsequent hospitalization, and mortality during ID-related ED visits compared to non-IDD adults. Adults with IDD continued to experience higher risks even after accounting for sociodemographic, hospital, and clinical characteristics. Septicemia and respiratory tract infections are the leading causes of ED visits, hospitalization, and mortality. This study found substantial disparities in ID-related ED visits, subsequent hospitalization, and mortality among the burdens for adults with IDD. These observations underscore the importance of integrated strategies to reduce ID-related morbidity among adults with IDD.
关于 COVID-19 对智力和发育障碍(IDD)患者不成比例影响的新证据表明,该人群中传染病(IDs)的潜在风险和负担。本研究的目的是检查与 ID 相关的急诊就诊(ED)、随后住院和住院相关死亡率在 IDD 成人与非 IDD 成人中的风险。作者使用 2016 年全国急诊样本进行了回顾性研究。该样本包括 94928 名使用 ICD-10-CM 代码确定的 IDD 成人,以及按年龄和性别以 1:3 的病例对照比匹配的 284763 名非 IDD 成人。使用泊松回归模型比较了 IDD 成人与非 IDD 成人在与 ID 相关的 ED 就诊、随后住院和住院相关死亡率方面的 ID 相关 ED 就诊、随后住院和住院相关死亡率风险。协变量包括社会人口统计学和医院特征。结果表明,与非 IDD 成人相比,IDD 成人在与 ID 相关的 ED 就诊、随后住院和 ED 就诊期间的死亡率方面风险更高。即使考虑到社会人口统计学、医院和临床特征,IDD 成人仍继续面临更高的风险。败血症和呼吸道感染是 ED 就诊、住院和死亡的主要原因。本研究发现 IDD 成人在与 ID 相关的 ED 就诊、随后住院和死亡率方面存在巨大差异。这些观察结果强调了制定综合策略以减少 IDD 成人 ID 相关发病率的重要性。