Xie Kristal, Blanchard Ashley, Chihuri Stanford, Russell Matthew, Ing Caleb, DiGuiseppi Carolyn, Li Guohua
Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
J Autism Dev Disord. 2025 Mar 27. doi: 10.1007/s10803-025-06769-0.
Children with autism spectrum disorder (ASD) are at heightened risk of unintentional drowning. We examined the epidemiological patterns of unintentional drowning incidents involving children diagnosed with ASD treated in US emergency departments (EDs). Data for this study came from the 2016-2020 Nationwide ED Sample. Children aged 1-19 years diagnosed with ASD and treated in EDs were identified using ICD-10-CM code F84.0. Weighted multivariable logistic regression models were used to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI) of drowning-related ED visits associated with ASD. During the study period, there were an estimated 21,226 unintentional drowning-related ED visits in children, including 369 in children diagnosed with ASD. Compared to children without ASD, ED visits for unintentional drownings in children with ASD were more likely to have occurred in swimming pools (47.45% vs. 41.21%), natural water (15.55% vs. 8.82%), and bathtubs (8.08% vs. 4.79%). Among children with ASD, unintentional drowning-related ED visits occurred more commonly in children > 10 years (43.20% vs. 18.19%) and were more likely to result in hospital admission (35.14% vs. 22.02%) than among children without ASD. With adjustment for demographic characteristics, ASD was associated with more than a 2-fold increased odds of ED-treated unintentional drowning (aOR = 2.31; 95% CI 1.84, 2.89). Epidemiologic patterns of unintentional drowning are different between children with and without ASD. Targeted interventions designed to increase supervision, provide adaptive swimming lessons, and enhance environmental safety may reduce the risk of unintentional drownings among children diagnosed with ASD.
患有自闭症谱系障碍（ASD）的儿童意外溺水风险更高。我们研究了美国急诊科（EDs）治疗的被诊断为ASD的儿童意外溺水事件的流行病学模式。本研究的数据来自2016 - 2020年全国急诊科样本。使用ICD - 10 - CM编码F84.0识别在急诊科接受治疗的1 - 19岁被诊断为ASD的儿童。采用加权多变量逻辑回归模型来估计与ASD相关的溺水相关急诊科就诊的调整优势比（aOR）和95%置信区间（CI）。在研究期间，估计有21226例儿童意外溺水相关的急诊科就诊，其中369例是被诊断为ASD的儿童。与没有ASD的儿童相比，患有ASD的儿童因意外溺水的急诊科就诊更有可能发生在游泳池（47.45%对41.21%）、天然水域（15.55%对8.82%）和浴缸（8.08%对4.79%）。在患有ASD的儿童中，意外溺水相关的急诊科就诊在10岁以上儿童中更常见（43.20%对18.19%），并且比没有ASD的儿童更有可能导致住院（35.14%对22.02%）。在调整人口统计学特征后，ASD与急诊科治疗的意外溺水几率增加两倍多相关（aOR = 2.31；95% CI 1.84，2.89）。患有和未患有ASD的儿童意外溺水的流行病学模式不同。旨在加强监管、提供适应性游泳课程和提高环境安全性的针对性干预措施可能会降低被诊断为ASD的儿童意外溺水的风险。
