Increased risk of head injury in pediatric patients with attention deficit hyperactivity disorder

J Child Adolesc Psychiatr Nurs. 2019 Nov;32(4):171-176. doi: 10.1111/jcap.12246. Epub 2019 Jul 21.

Abstract

Objective: The prevalence of attention deficit hyperactivity disorder (ADHD) in the general pediatric population is 7%, whereas the prevalence in trauma is unknown. We hypothesized pediatric patients with ADHD would have a higher risk of involvement in a mechanism of injury (MOI) requiring constant attention to surroundings, such as a bicycle collision.

Methods: The Pediatric Trauma Quality Improvement Program (2014-2016) was queried for patients with ADHD. Patients, less than 16 years of age, with ADHD were compared to those without ADHD.

Results: The prevalence of ADHD was 2.5% (2,866). ADHD patients had higher risk for bicycle collision (odds ratio [OR], 1.85; 95% confidence interval [CI], 1.59-2.15; p < .001). ADHD bicyclists were less likely to wear a helmet (9.4% vs. 18.2%, p = .003) and had a higher rate of traumatic brain injury (TBI; 55.6% vs. 39.7%, p < .001), compared to non-ADHD bicyclists.

Conclusions: Pediatric ADHD patients have a 60% higher risk of being involved in a bicycle collision. ADHD patients that are involved in a bicycle collision are less likely to wear a helmet with a higher rate of TBI. Increased public awareness, education, and supervision may help reduce risk of bicycle collisions and TBI in this population.

Keywords: ADHD; bicycle; collisions; traumatic brain injury.

MeSH terms

  • Accidental Falls / statistics & numerical data
  • Accidents, Traffic / statistics & numerical data
  • Attention Deficit Disorder with Hyperactivity / complications*
  • Bicycling / injuries
  • Brain Injuries, Traumatic / etiology
  • Case-Control Studies
  • Child
  • Craniocerebral Trauma / etiology*
  • Female
  • Head Protective Devices / statistics & numerical data
  • Humans
  • Male
  • Retrospective Studies
  • Risk Factors
  • Wounds, Gunshot / etiology
  • Wounds, Stab / etiology