Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, 10032, New York, NY, USA.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
J Autism Dev Disord. 2024 Oct;54(10):3630-3638. doi: 10.1007/s10803-023-06091-7. Epub 2023 Aug 16.
The reported prevalence of autism spectrum disorder (ASD) has more than tripled in the past two decades in the United States, due in part to improved screening and diagnostic techniques. Epidemiologic data on ASD, however, are largely limited to population-based surveillance systems. We examined epidemiologic patterns in ASD diagnoses among inpatients aged 1-20 years, using data from the Kids' Inpatient Database (KID) from 1997 to 2019. ASD cases were identified using ICD-9-CM and ICD-10-CM codes. Of 9,267,881 hospital discharges studied, 110,090 (1.19%) had a diagnosis of ASD. The prevalence of ASD was higher among males compared to females (1.53% vs. 0.54%) and was highest among non-Hispanic Whites (1.28% vs. 0.95% in non-Hispanic Blacks, 0.94% in Hispanics, and 1.18% in Other races). ASD prevalence increased from 0.18% to 1997 to 3.36% in 2019 (Z= -273.40, p < 0.001). The absolute increase was higher among males compared to females (0.26-4.90% vs. 0.08-1.77%) and among non-Hispanic Whites (0.18-2.88%) compared to non-Hispanic Blacks (0.23-2.72%), Hispanics (0.14-2.60%), and Other races (0.19-2.97%). The epidemiologic patterns of ASD based on inpatient data are generally consistent with reports from the community-based autism surveillance system. Our findings indicate that KID and other health services data might play a complementary role in ASD surveillance.
在美国，过去二十年中自闭症谱系障碍 (ASD) 的报告患病率增加了两倍多，部分原因是筛查和诊断技术的提高。然而，ASD 的流行病学数据主要限于基于人群的监测系统。我们使用了 1997 年至 2019 年期间 Kids' Inpatient Database (KID) 的数据，研究了住院患者中 1-20 岁 ASD 诊断的流行病学模式。使用 ICD-9-CM 和 ICD-10-CM 代码来识别 ASD 病例。在所研究的 9267881 例住院患者中，有 110090 例（1.19%）被诊断为 ASD。与女性相比，男性的 ASD 患病率更高（1.53%比 0.54%），非西班牙裔白人的 ASD 患病率最高（1.28%比非西班牙裔黑人的 0.95%、西班牙裔的 0.94%和其他种族的 1.18%）。ASD 的患病率从 1997 年的 0.18%增加到 2019 年的 3.36%（Z=-273.40，p<0.001）。与女性相比，男性的绝对增加更高（0.26-4.90%比 0.08-1.77%），与非西班牙裔白人相比，非西班牙裔黑人（0.18-2.88%）、西班牙裔（0.14-2.60%）和其他种族（0.19-2.97%）的增加更高。基于住院患者数据的 ASD 流行病学模式与基于社区的自闭症监测系统的报告基本一致。我们的研究结果表明，KID 和其他卫生服务数据可能在 ASD 监测中发挥互补作用。
