Identified attention-deficit/hyperactivity disorder and medically attended, nonfatal injuries: US school-age children, 1997-2002

Abstract

Objective: To determine the medically attended, nonfatal injury rate among children 6-17 years of age ever and never identified with attention-deficit/hyperactivity disorder (ADHD).

Methods: An analysis was performed of parentally reported injury episodes during the past 3 months and current demographic characteristics of 3,741 sample children ever identified with ADHD and 48,243 never identified with ADHD in the 1997-2002 National Health Interview Surveys.

Results: The annualized rate of injury was 204 episodes per 1,000 among children with ADHD compared with 115 episodes per 1,000 among children without ADHD. Injury episode rates were higher for children with ADHD regardless of age, sex, or health insurance. Logistic regression, which controlled for confounding risk factors, showed a robust association between ADHD and injury. The adjusted odds ratio (OR) for ADHD (OR(adj) = 1.83) was similar to the ORs for other important predictors of injury, such as male sex (OR(adj) = 1.45), older age (OR(adj) = 1.50), and private health insurance (OR(adj) = 1.44). Children with other health conditions had an increased odds for injury (OR(adj) = 1.51 for children with other developmental disorders and OR(adj) = 1.53 for children with physical disorders). Characteristics of injury episodes were generally similar for children with and without ADHD.

Conclusions: Results from a large, nationally representative sample indicate that children ever identified with ADHD were more likely to have a medically attended, nonfatal injury than children never identified with ADHD. The increased odds of injury among children with ADHD could not be attributed to other confounding risk factors. Children with ADHD may benefit from targeted injury prevention efforts.