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Vu H, Bowden N, Gibb S, Audas R, Dacombe J, McLay L, Sporle A, Stace H, Taylor B, Thabrew H, Theodore R, Tupou J, Schluter PJ. Mortality risk among Autistic children and young people: A nationwide birth cohort study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2244-2253. [PMID: 38311609 PMCID: PMC11395172 DOI: 10.1177/13623613231224015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
LAY ABSTRACT Existing literature indicates that Autistic people have shorter life expectancy, but little is known about the mortality risk among Autistic children and young people (0-24 years). We used a 15-year nationwide birth cohort study to estimate the mortality risk among Autistic children and young people in Aotearoa/New Zealand. The study included 895,707 children and 11,919 (1.4%) were Autistic. We found that autism was associated with a significantly higher mortality risk compared to the non-Autistic population. In addition, we found that this risk was significantly higher among females compared to males and for those with a co-occurring intellectual disability. Increased efforts are required to better meet the health needs of this population.
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Affiliation(s)
- Hien Vu
- University of Otago, Dunedin, New Zealand
| | - Nicholas Bowden
- University of Otago, Dunedin, New Zealand
- National Science Challenge, New Zealand
| | - Sheree Gibb
- National Science Challenge, New Zealand
- University of Otago, Wellington, New Zealand
| | - Richard Audas
- Memorial University of Newfoundland and Labrador, Canada
| | | | | | - Andrew Sporle
- INZight Analytics Ltd., New Zealand
- University of Auckland, New Zealand
| | | | - Barry Taylor
- University of Otago, Dunedin, New Zealand
- National Science Challenge, New Zealand
| | - Hiran Thabrew
- National Science Challenge, New Zealand
- University of Auckland, New Zealand
| | | | | | - Philip J Schluter
- National Science Challenge, New Zealand
- University of Canterbury, New Zealand
- University of Queensland, Australia
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Mazur LE, Even KM, Krawiec C. Retrospective Analysis of Burn Injuries in Children with Autism Spectrum Disorder. J Autism Dev Disord 2024:10.1007/s10803-024-06334-1. [PMID: 38607476 DOI: 10.1007/s10803-024-06334-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 04/13/2024]
Abstract
Children with neurodevelopmental disorders are at risk for burn injury, but the clinical outcomes, particularly mortality, are unknown in this patient population in the United States (U.S.). The main objectives of this study are to evaluate (1) subject characteristics; (2) burn injury type; (3) clinical care provided; and (4) mortality in children with autism spectrum disorder (ASD), hypothesizing that this patient population has similar mortality and critical care management requirements when compared to children without ASD. This is a retrospective observational cohort study utilizing the TriNetX ® electronic health record database of subjects aged 0 to 18 years with burn injury associated diagnostic codes. Data were analyzed for demographics, diagnostic, medication, procedural codes, and mortality. We analyzed 99,323 subjects (n, %) coded for a burn injury [3083 (3.1%) with ASD and 96,240 (96.9%) without ASD]. Children with ASD had a higher odds of 1-year all-cause mortality [1.9 (1.06, 3.40), p = 0.004], need for critical care services [1.88 (1.40, 2.52), p < 0.001], and mechanical ventilation [2.69 (1.74, 4.17), p < 0.001] compared to those without. Our study found that U.S. children with ASD who had a burn injury had a higher odds of mortality and critical care needs when compared to children without ASD. Future studies are needed to understand the impact of burn injuries and factors associated with mortality in this patient population.
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Affiliation(s)
- Lauren E Mazur
- Penn State College of Medicine, 500 University Drive, P.O. Box 850, Hershey, PA, 17033-0850, USA.
| | - Katelyn M Even
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children's Hospital, 500 University Drive, P.O. Box 850, Hershey, PA, 17033-0850, USA
| | - Conrad Krawiec
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children's Hospital, 500 University Drive, P.O. Box 850, Hershey, PA, 17033-0850, USA
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Huang YH, Wu SI, Lee MJ, Chen YL, Yang YH, Kuo TY, Hung TH, Dewey ME, Stewart R, Chen VCH. Excess Mortality in Individuals with Autism Spectrum Disorder: A Population-Based Cohort Study. Neuropsychiatr Dis Treat 2024; 20:247-255. [PMID: 38348059 PMCID: PMC10860845 DOI: 10.2147/ndt.s437766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
Purpose Autism spectrum disorder (ASD) may be associated with increased mortality, but relevant findings have been inconsistent. The modifying effects of gender and intellectual disability on excess mortality in individuals with ASD are underexplored. Patients and Methods Using Taiwan's National Health Insurance Research Database and the National Death Registry, this population-based cohort study selected the data of 75,946 patients with ASD (ASD cohort) and 75,946 age group-, gender-, and income-matched (1:1) patients without ASD (non-ASD cohort). Cox proportional hazards models were used to compare mortality rates between the cohorts, and stratified analyses were used to evaluate the influence of gender and intellectual disability on mortality risk. Results The ASD cohort had higher mortality rates for all causes of death than did the non-ASD cohort (adjusted hazard ratio 1.64, 95% confidence interval 1.54-1.75). Comorbid intellectual disability was associated with an increased risk of mortality, and this association was stronger in female patients than in male patients. Moreover, when focusing on deaths from natural causes, we found a significantly higher odds ratio for mortality in the ASD population with ID compared to those without ID. Conclusion ASD is associated with increased mortality, especially among female individuals and those with intellectual disability.
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Affiliation(s)
- Yu-Hsin Huang
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- Department of Psychiatry, MacKay Memorial Hospital, Taipei City, Taiwan
| | - Shu-I Wu
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- Department of Psychiatry, MacKay Memorial Hospital, Taipei City, Taiwan
| | - Min-Jing Lee
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
| | - Ting-Yu Kuo
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
| | - Tai-Hsin Hung
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Michael E Dewey
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Robert Stewart
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley National Health Services Foundation Trust, London, UK
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
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赵 亚, 范 慧, 王 翔, 罗 雅, 张 嵘, 郑 晓. [Early death and causes of death of patients with autism spectrum disorders: A systematic review]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:375-383. [PMID: 37042154 PMCID: PMC10091241 DOI: 10.19723/j.issn.1671-167x.2023.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Indexed: 06/20/2023]
Abstract
To study of premature/early death of autistic patients from the perspective of life course can help families, medical institutions and policy makers better deal with the adverse effects of autism. Several studies have shown that autistic patients have a high risk of death, however, the results are still inconsistent. To assess the risk of mortality among the autistic patients, we undertook a comprehensive search of MEDLINE, Web of Science and EMBASE databases. This paper reviewed the studies on the negative disease outcomes of autism spectrum disorders, including the risk of death, causes of death and several research hotspots in this field. Strict inclusion/exclusion criteria were used. Information was extracted from selected papers, tabulated and synthesized. In the study, 15 studies were included, with a total of 216 045 individuals. The main outcome was all-cause mortality in association with autism and the secondary outcome was cause-specific mortality. The results showed that all-cause mortality was higher for the autistic patients (RR=2.32, 95%CI: 1.98-2.72, I2=87.1%, P < 0.001). Risk ratio showed a greater inequality for female than male (male: RR=2.00, 95%CI: 1.57-2.55, I2=93.2%, P < 0.001; female: RR=4.66, 95%CI: 3.30-6.58, I2=92.0%, P < 0.001). Compared with the unnatural death, the risk of natural death was higher (RR=3.44, 95%CI: 1.27-9.26, I2=80.2%, P=0.025). As autism had many comorbidities, which would bring more health risks and natural deaths possibilities. There were some structural differences in unnatural death. Accidental injury death and suicide were two kinds of causes. Lacking social skills would weaken the ability to ask for help when encountering injuries. This paper put forward some suggestions for futures. First, to well study the comorbidity can reduce the risk of death from a medical point of view. Second, the scientists and policymakers should pay attention to the social environment and provide a safer environment for the autistic patients. Third, for women and for adolescents without cognitive impairment, due to their high risk of suicide, the society should provide them with more supportive social networks and improve their life satisfaction. Fourth, it is necessary to balance the rehabilitation resources in various regions in China and provide more high-quality lifelong rehabilitation monitoring and care services.
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Affiliation(s)
- 亚楠 赵
- 中国医学科学院, 北京协和医学院群医学与公共卫生学院, 北京 100730School of Population Medicine and Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
- 北京大学中国卫生发展研究中心, 北京 100191China Center for Health Development Studies, Peking University, Beijing 100191, China
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
| | - 慧芸 范
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
- 北京大学人口研究所, 北京 100871Institute of Population Research, Peking University, Beijing 100871, China
| | - 翔宇 王
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
- 北京大学人口研究所, 北京 100871Institute of Population Research, Peking University, Beijing 100871, China
| | - 雅楠 罗
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
- 北京大学公共卫生学院全球卫生学系, 北京 100191Department of Global Health, Peking University School of Public Health, Beijing 100191, China
| | - 嵘 张
- 北京大学神经科学研究所, 北京大学基础医学院神经生物学系, 神经科学教育部重点实验室, 卫生部神经科学重点实验室, 北京 100191Neuroscience Research Institute, Peking University; Department of Neurobiology, Peking University School of Basic Medical Sciences; Key Laboratory for Neuroscience of the Ministry of Education; Key Laboratory for Neuroscience of the Ministry of National Health Commission; Beijing 100191, China
- 北京大学医学部孤独症研究中心, 北京 100191Autism Research Centre, Peking University Health Science Centre, Beijing 100191, China
| | - 晓瑛 郑
- 中国医学科学院, 北京协和医学院群医学与公共卫生学院, 北京 100730School of Population Medicine and Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
- 北京大学医学部孤独症研究中心, 北京 100191Autism Research Centre, Peking University Health Science Centre, Beijing 100191, China
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