Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
J Adolesc Health. 2022 Aug;71(2):172-179. doi: 10.1016/j.jadohealth.2022.02.008. Epub 2022 Apr 13.
Adolescents with attention-deficit/hyperactivity disorder (ADHD) have 30%-40% higher crash rates. However, we still do not understand which factors underlie heightened crash risk and if crash circumstances differ for drivers with ADHD. We compared prevalences of crash responsibility, driver actions, and crash types among adolescent and young adult drivers with and without ADHD who crashed within 48 months of licensure.
In this exploratory retrospective cohort study, we identified patients of Children's Hospital of Philadelphia's (CHOP) New Jersey (NJ) primary care locations who were born between 1987 and 2000, NJ residents, had their last CHOP visit ≥ age 12 years, and acquired a driver's license. We linked CHOP electronic health records to NJ's licensing and crash databases. ADHD diagnosis was based on International Classification of Diseases, Ninth Revision, Clinical Modification/International Classification of Diseases, Tenth Revision, Clinical Modification codes. Prevalence ratios were estimated using generalized estimating equation log-binomial regression.
We identified 934 drivers with ADHD in 1,308 crashes and 5,158 drivers without ADHD in 6,676 crashes. Within 48 months postlicensure, drivers with ADHD were more likely to be at fault for their crash (prevalence ratio: 1.09 [1.05-1.14]) and noted as inattentive (1.15 [1.07-1.23]). With the exception that drivers with ADHD were less likely to crash while making a left/U-turn, we did not find substantial differences in crash types by diagnosis. Analyses also suggest females with ADHD may have a higher risk of colliding with a nonmotor vehicle and crashing due to unsafe speed than females without ADHD.
The results suggest crash circumstances do not widely differ for drivers with and without ADHD but highlight several factors that may be particularly challenging for young drivers with ADHD.
患有注意力缺陷多动障碍（ADHD）的青少年发生撞车事故的风险要高出 30%-40%。然而，我们仍然不清楚哪些因素导致了更高的撞车风险，以及 ADHD 患者的撞车情况是否有所不同。我们比较了在获得驾照后 48 个月内发生撞车事故的 ADHD 青少年和年轻成年司机与无 ADHD 司机之间的撞车责任、司机行为和撞车类型的发生率。
在这项探索性回顾性队列研究中，我们确定了费城儿童医院新泽西（NJ）初级保健地点的患者，这些患者出生于 1987 年至 2000 年之间，是 NJ 居民，在 CHOP 的最后一次就诊年龄≥12 岁，并获得了驾照。我们将 CHOP 电子健康记录与 NJ 的许可和撞车数据库进行了链接。ADHD 的诊断基于国际疾病分类，第九修订版，临床修正/国际疾病分类，第十修订版，临床修正代码。使用广义估计方程对数二项式回归估计患病率比。
我们在 1308 起撞车事故中确定了 934 名患有 ADHD 的司机，在 6676 起撞车事故中确定了 5158 名没有 ADHD 的司机。在获得驾照后的 48 个月内，患有 ADHD 的司机更有可能对其撞车事故负责（患病率比：1.09 [1.05-1.14]），并且被记录为注意力不集中（1.15 [1.07-1.23]）。除了 ADHD 司机更不可能在左转弯/掉头时发生撞车事故外，我们没有发现诊断结果对撞车类型有显著差异。分析还表明，患有 ADHD 的女性比没有 ADHD 的女性更有可能与非机动车辆碰撞并因超速而发生撞车事故。
结果表明，患有 ADHD 和没有 ADHD 的司机的撞车情况并没有广泛不同，但强调了一些可能对患有 ADHD 的年轻司机特别具有挑战性的因素。
