In-hospital mortality among adults with autism spectrum disorder in the United States: A retrospective analysis of US hospital discharge data

Autism ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 177-189 ◽  
Author(s):  
Ilhom Akobirshoev ◽  
Monika Mitra ◽  
Robbie Dembo ◽  
Emily Lauer
Keyword(s):  
United States ◽  
Autism Spectrum Disorders ◽  
Confidence Interval ◽  
Hospital Mortality ◽  
Odds Ratio ◽  
The United States ◽  
Autism Spectrum ◽  
Adults With Autism ◽  
Inpatient Hospital ◽  
Spectrum Disorders

A retrospective data analysis using 2004–2014 Healthcare Cost and Utilization Project Nationwide Inpatient Sample was conducted to examine in-hospital mortality among adults with autism spectrum disorders in the United States compared to individuals in the general population. We modeled logistic regressions to compare inpatient hospital mortality between adults with autism spectrum disorders (n = 34,237) and age-matched and sex-matched controls (n = 102,711) in a 1:3 ratio. Adults with autism spectrum disorders had higher odds for inpatient hospital mortality than controls (odds ratio = 1.44, 95% confidence interval: 1.29–1.61, p < 0.001). This risk remained high even after adjustment for age, sex, race/ethnicity, income, number of comorbidities, epilepsy and psychiatric comorbidities, hospital bed size, hospital region, and hospitalization year (odds ratio = 1.51, 95% confidence interval: 1.33–1.72, p < 0.001). Adults with autism spectrum disorders who experienced in-hospital mortality had a higher risk for having 10 out of 27 observed Elixhauser-based medical comorbidities at the time of death, including psychoses, other neurological disorders, diabetes, hypothyroidism, rheumatoid arthritis collagen vascular disease, obesity, weight loss, fluid and electrolyte disorders, deficiency anemias, and paralysis. The results from the interaction of sex and autism spectrum disorders status suggest that women with autism spectrum disorders have almost two times higher odds for in-hospital mortality (odds ratio = 1.95, p < 0.001) than men with autism spectrum disorders. The results from the stratified analysis also showed that women with autism spectrum disorders had 3.17 times higher odds (95% confidence interval: 2.50–4.01, p < 0.001) of in-hospital mortality compared to women from the non–autism spectrum disorders matched control group; this difference persisted even after adjusting for socioeconomic, clinical, and hospital characteristics (odds ratio = 2.75, 95% confidence interval: 2.09–3.64, p < 0.001). Our findings underscore the need for more research to develop better strategies for healthcare and service delivery to people with autism spectrum disorders.

Costs of Autism Spectrum Disorders in the United Kingdom and the United States

2014 ◽  
Vol 168 (8) ◽  
pp. 721 ◽  
Author(s):  
Ariane V. S. Buescher ◽  
Zuleyha Cidav ◽  
Martin Knapp ◽  
David S. Mandell
Keyword(s):  
United States ◽  
United Kingdom ◽  
Autism Spectrum Disorders ◽  
The United States ◽  
Autism Spectrum ◽  
The United Kingdom ◽  
Spectrum Disorders

CHARACTERISTICS OF NONTRAUMATIC SUBARACHNOID HEMORRHAGE IN THE UNITED STATES IN 2003

Neurosurgery ◽  
2007 ◽  
Vol 61 (6) ◽  
pp. 1131-1138 ◽  
Author(s):  
Alisa M. Shea ◽  
Shelby D. Reed ◽  
Lesley H. Curtis ◽  
Michael J. Alexander ◽  
John J. Villani ◽  
...  
Keyword(s):  
United States ◽  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Confidence Interval ◽  
Hospital Mortality ◽  
Odds Ratio ◽  
The United States ◽  
National Database ◽  
Endovascular Coiling ◽  
Hospital Outcomes

Abstract OBJECTIVE Substantial progress has been made in the diagnosis and treatment of subarachnoid hemorrhage (SAH). However, studies of SAH in the United States do not include information more recent than 2001, precluding analysis of shifts in treatment methods. We examined the epidemiology and in-hospital outcomes of nontraumatic SAH in the United States. METHODS We analyzed nationally representative data from the 2003 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project to determine demographic and hospital characteristics, treatments, and in-hospital outcomes of patients with nontraumatic SAH. RESULTS In 2003, there were an estimated 31,476 discharges for nontraumatic SAH among patients aged 17 years or older, or 14.5 discharges per 100,000 adults. The in-hospital mortality rate was 25.3%. Microvascular clipping was performed in 7513 discharges, or 23.9% of inpatients with nontraumatic SAH; endovascular coiling was performed in 2849 discharges (9.1%). Adjusted odds of treatment with either procedure were significantly higher in urban teaching hospitals compared with urban nonteaching hospitals (odds ratio, 1.62; 95% confidence interval, 1.00–2.62) or rural hospitals (odds ratio, 3.08; 95% confidence interval, 1.93–4.91). CONCLUSION The in-hospital mortality rate associated with nontraumatic SAH continues to exceed 25%. Although it is unclear how many patients with nontraumatic SAH were actually diagnosed with a cerebral aneurysm, this study suggests that less than one-third of patients hospitalized for SAH receive surgical or endovascular treatment. Prospective studies are needed to elucidate either what systematic coding error is occurring in the national database or why patients may not receive treatment to secure a ruptured aneurysm.

scholarly journals Development of Communication in Children with Autism Spectrum Disorders in the United States and Russia

2016 ◽  
Vol 21 (3) ◽  
pp. 56-66
Author(s):  
R.L. Esterbrook ◽  
S.A. Esterbrook ◽  
A. Dreyfus ◽  
T.A. Karpekova ◽  
E.N. Soldatenkova
Keyword(s):  
United States ◽  
Autism Spectrum Disorders ◽  
Children With Autism ◽  
Communication Disorders ◽  
The United States ◽  
Autism Spectrum ◽  
Children With Asd ◽  
Important Idea ◽  
Spectrum Disorders ◽  
And Function

The article presents an analysis of theoretical principles and methodological approaches within the framework of research schools both in the United States and Russia; these schools provide the basis for the development of effective learning and communication skills for children with Autism Spectrum Disorders (ASD). The authors consider the indicators for communication disorders in children with ASD, as well as the main strategies for overcoming them in the context of utilizing verbal behavior analysis (B.F. Skinner, M.L. Sundberg, J.W. Partington, and M.L. Barbera - USA), the tradition of cultural-historical psychology (L.S. Vygotsky, D.B. Elkonin, B.D. Elkonin - Russia), reflective-activity approach (A.N. Leontiev, V.K. Zaretsky – Russia), the theory of systemic dynamic localization of higher mental functions(A.R. Luria – Russia), and method of ”replacing ontogenesis” (B.A. Arkhipov, A.V. Semenovich Russia). Despite the differences in methodologies used by American and Russian scholars, the most important idea is that the researchers and practitioners of both schools have common goal: to concentrate their efforts on developing social interaction skills in children with ASD, which helps them to better adjust in their lives and function in the social environment.

scholarly journals Association of Autism Spectrum Disorders With Neonatal Hyperbilirubinemia

2015 ◽  
Vol 2 ◽  
pp. 2333794X1559651 ◽  
Author(s):  
Luis E. Lozada ◽  
Cade M. Nylund ◽  
Gregory H. Gorman ◽  
Elizabeth Hisle-Gorman ◽  
Christine R. Erdie-Lalena ◽  
...  
Keyword(s):  
Autism Spectrum Disorders ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Neurodevelopmental Disorder ◽  
Autism Spectrum ◽  
Unknown Etiology ◽  
Military Health ◽  
Spectrum Disorders ◽  
Procedure Codes ◽  
The Military

Autism spectrum disorders (ASD) are a common neurodevelopmental disorder of unknown etiology. Studies suggest a link between autism and neonatal jaundice. A 1:3 matched case–control study was conducted with children enrolled in the Military Health System born between October 2002 and September 2009. Diagnostic and procedure codes were used for identifying ASD and hyperbilirubinemia. Two definitions for hyperbilirubinemia were evaluated: an inpatient admission with a diagnosis of jaundice and treatment with phototherapy. A total of 2917 children with ASD and 8751 matched controls were included in the study. After adjustment, there remained an association between ASD in children and an admission with a diagnosis of jaundice (odds ratio = 1.18; 95% confidence interval = 1.06-1.31; P = .001) and phototherapy treatment (odds ratio = 1.33; 95% confidence interval = 1.04-1.69; P = .008). Children who develop ASD are more likely to have an admission with a diagnosis of jaundice in the neonatal period and more likely to require treatment for this jaundice.

scholarly journals Profession of a tutor in national and foreign practice

2016 ◽  
Vol 5 (3) ◽  
pp. 75-82 ◽  
Author(s):  
T.M. Ovsyannikova
Keyword(s):  
United States ◽  
Autism Spectrum Disorders ◽  
School Environment ◽  
Children With Autism ◽  
The United States ◽  
Autism Spectrum ◽  
Foreign Experience ◽  
Inclusive School ◽  
Spectrum Disorders

The paper presents the phenomenon of tutoring in support of children with autism spectrum disorders (ASD) in Israel, the United States and Russia. It describes the role of a tutor, as a member of the team of teachers in creating an inclusive school environment for students with ASD. Special attention is paid to the issues of competencies and skills necessary for a tutor. Consolidated national and foreign experience of tutoring made it possible to articulate the proposal aimed at formation of a new professional function for teachers in Russia - a specialist in the ASD

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