Department of Psychiatry, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.
School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Psychiatry Clin Neurosci. 2022 Dec;76(12):652-658. doi: 10.1111/pcn.13471. Epub 2022 Sep 24.
Patients with attention deficit hyperactivity disorder (ADHD) are prone to injury and frequently require treatment with hospital admission. This study aimed to evaluate the risk of injuries requiring hospitalization among children and adolescents with and without ADHD and assess the effects of medication on the risk reduction in patients with ADHD.
This is a retrospective population-based cohort study by using data from the Taiwan National Health Insurance Research Database. We compared 4658 6-18 year-old ADHD patients with 18 632 sex-, age-, and index day-matched non-ADHD controls between 2005 and 2012. Both groups were followed until the end of 2013 to compare the risk of injuries requiring hospitalization. Cox regression analysis was performed to determine the hazard ratio (HR) with 95% confidence intervals (CI) after adjusting for confounders.
Children and adolescents with ADHD had a significantly higher risk of injuries requiring hospitalization than the non-ADHD controls (HR = 1.39, 95% CI = 1.12-1.72), and a higher risk was especially observed in the male and adolescent subgroups. In ADHD patients, long-term users of ADHD medication were associated with a lower risk of injuries requiring hospitalization than nonusers (HR = 0.51, 95% CI = 0.30-0.85).
Healthcare providers should be aware of the potential risk of injury in patients with ADHD and highlight the importance of the duration and compliance with medication treatment.
患有注意力缺陷多动障碍（ADHD）的患者容易受伤，经常需要住院治疗。本研究旨在评估患有和不患有 ADHD 的儿童和青少年因伤住院的风险，并评估药物治疗对 ADHD 患者降低风险的影响。
这是一项基于人群的回顾性队列研究，使用了来自台湾全民健康保险研究数据库的数据。我们将 2005 年至 2012 年期间的 4658 名 6-18 岁的 ADHD 患者与 18632 名性别、年龄和索引日匹配的非 ADHD 对照组进行比较。两组均随访至 2013 年底，以比较因伤住院的风险。采用 Cox 回归分析调整混杂因素后确定危险比（HR）及其 95%置信区间（CI）。
与非 ADHD 对照组相比，患有 ADHD 的儿童和青少年因伤住院的风险显著更高（HR=1.39，95%CI=1.12-1.72），尤其是在男性和青少年亚组中。在 ADHD 患者中，长期使用 ADHD 药物治疗的患者因伤住院的风险低于未使用者（HR=0.51，95%CI=0.30-0.85）。
医疗保健提供者应意识到 ADHD 患者受伤的潜在风险，并强调药物治疗的持续时间和依从性的重要性。
