Does attention-deficit/hyperactivity disorder increase the risk of minor blunt head trauma in children?
Murat Pakyurek, Mohamed Badawy, Irma T Ugalde and 6 others
PMID 35962779WHAT IT FOUND
ADHD was diagnosed in 8.0% of children with minor blunt head trauma, not higher overall than in passenger MVC children, but higher after assaults, bicycle crashes, and auto versus pedestrian injuries; ADHD was not associated with higher cranial CT use.
Key findings
01ADHD was diagnosed in 274 of 3,410 children (8.0%, 95% CI 7.1 to 9.0%), and 162 of those children (60%) were reported to take ADHD medications.
02ADHD rates were statistically higher after assaults, automobile versus pedestrian incidents, and bicycle crashes than after passenger MVC mechanisms.
03After adjusting for age, sex, and PECARN head-injury variables, ADHD was not associated with cranial CT scanning (odds ratio 1.17, 95% CI 0.85 to 1.61, p=0.35).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The comparison group was children injured as MVC passengers, which may not represent the ADHD rate in the general population. ADHD was identified by guardian report or medical records, not formal testing, so children with undiagnosed ADHD may have been missed. The analysis excluded children younger than four years and those 16 years or older, and excluded moderate-to-severe head injury with Glasgow Coma Scale scores below 14. 660 children did not have ADHD status; the paper says their age and cranial CT use were similar to the analyzed group. ADHD subtypes and detailed medication information were not analyzed, so the study cannot say which ADHD features or treatment status relate to injury. Because it was observational, it cannot show that ADHD caused head trauma or that injury prevention counselling will reduce trauma.
Declared interests
The supplied text does not include an author conflict-of-interest declaration. The publication types list NIH extramural research support.
The easy way to misread this
Do not conclude that ADHD increases overall minor blunt head trauma risk. The overall non-MVC versus passenger MVC comparison was not significant, only selected mechanisms had higher ADHD rates, and the observational design cannot show that ADHD caused the injuries.