Impact of ASD and ADHD on pediatric asthma exacerbations: a retrospective analysis of the Nationwide Inpatient Sample 2005–2020

Abstract Background To explore the impact of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) on in-hospital outcomes in children hospitalized for asthma exacerbations. Methods This retrospective study utilized data from the Nationwide Inpatient Sample (NIS) databas...

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Main Authors: Dai-Xuan Lin, Ya-Ting Chang, Yu-Chun Lo, Shih-Ming Weng
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-025-01974-0
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author Dai-Xuan Lin
Ya-Ting Chang
Yu-Chun Lo
Shih-Ming Weng
author_facet Dai-Xuan Lin
Ya-Ting Chang
Yu-Chun Lo
Shih-Ming Weng
author_sort Dai-Xuan Lin
collection DOAJ
description Abstract Background To explore the impact of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) on in-hospital outcomes in children hospitalized for asthma exacerbations. Methods This retrospective study utilized data from the Nationwide Inpatient Sample (NIS) database between 2005 and 2020. We included children aged 5 to 19 years admitted for asthma exacerbations. Children were categorized into four groups: those with ASD only, ADHD only, both ASD and ADHD, and neither condition. Propensity score matching was used to balance baseline characteristics. Results A total of 155,893 children hospitalized for asthma were identified, with 2,443 patients remaining after propensity score matching. Children with both ASD and ADHD had the highest total hospital costs, followed by those with ASD alone. Children with both ASD and ADHD had significantly increased risks of overall complications (aOR = 1.69, 95% CI: 1.27–2.26), including epilepsy (aOR = 3.56, 95% CI: 1.61–7.87), pneumonia (aOR = 2.00, 95% CI: 1.33–3.03), and constipation (aOR = 4.22, 95% CI: 1.58–11.26), compared to those without either condition. Children with ASD alone also had elevated risks for epilepsy (aOR = 3.79, 95% CI: 1.79–8.03) and constipation (aOR = 4.33, 95% CI: 1.78–10.54). Conclusion In the US children hospitalized for asthma exacerbations, those with both ASD and ADHD, or ASD alone, face significantly greater costs and higher risks of specific complications, particularly epilepsy, pneumonia, and constipation. The findings suggest a compounded impact of these neurodevelopmental conditions on asthma children, emphasizing the need for specialized care to manage these patients effectively and reduce the risks.
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spelling doaj-art-7027bf8288e54d609ab6ab9f8bdb37fc2025-08-20T01:49:47ZengBMCItalian Journal of Pediatrics1824-72882025-05-015111910.1186/s13052-025-01974-0Impact of ASD and ADHD on pediatric asthma exacerbations: a retrospective analysis of the Nationwide Inpatient Sample 2005–2020Dai-Xuan Lin0Ya-Ting Chang1Yu-Chun Lo2Shih-Ming Weng3Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health SciencesDivision of Pediatric Allergy and Immunology, Department of Pediatrics, Taiwan Adventist HospitalPhD Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical UniversityDepartment of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health SciencesAbstract Background To explore the impact of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) on in-hospital outcomes in children hospitalized for asthma exacerbations. Methods This retrospective study utilized data from the Nationwide Inpatient Sample (NIS) database between 2005 and 2020. We included children aged 5 to 19 years admitted for asthma exacerbations. Children were categorized into four groups: those with ASD only, ADHD only, both ASD and ADHD, and neither condition. Propensity score matching was used to balance baseline characteristics. Results A total of 155,893 children hospitalized for asthma were identified, with 2,443 patients remaining after propensity score matching. Children with both ASD and ADHD had the highest total hospital costs, followed by those with ASD alone. Children with both ASD and ADHD had significantly increased risks of overall complications (aOR = 1.69, 95% CI: 1.27–2.26), including epilepsy (aOR = 3.56, 95% CI: 1.61–7.87), pneumonia (aOR = 2.00, 95% CI: 1.33–3.03), and constipation (aOR = 4.22, 95% CI: 1.58–11.26), compared to those without either condition. Children with ASD alone also had elevated risks for epilepsy (aOR = 3.79, 95% CI: 1.79–8.03) and constipation (aOR = 4.33, 95% CI: 1.78–10.54). Conclusion In the US children hospitalized for asthma exacerbations, those with both ASD and ADHD, or ASD alone, face significantly greater costs and higher risks of specific complications, particularly epilepsy, pneumonia, and constipation. The findings suggest a compounded impact of these neurodevelopmental conditions on asthma children, emphasizing the need for specialized care to manage these patients effectively and reduce the risks.https://doi.org/10.1186/s13052-025-01974-0Autism spectrum disorder (ASD)Attention deficit hyperactivity disorder (ADHD)AsthmaChildrenIn-hospital mortalityComplication
spellingShingle Dai-Xuan Lin
Ya-Ting Chang
Yu-Chun Lo
Shih-Ming Weng
Impact of ASD and ADHD on pediatric asthma exacerbations: a retrospective analysis of the Nationwide Inpatient Sample 2005–2020
Italian Journal of Pediatrics
Autism spectrum disorder (ASD)
Attention deficit hyperactivity disorder (ADHD)
Asthma
Children
In-hospital mortality
Complication
title Impact of ASD and ADHD on pediatric asthma exacerbations: a retrospective analysis of the Nationwide Inpatient Sample 2005–2020
title_full Impact of ASD and ADHD on pediatric asthma exacerbations: a retrospective analysis of the Nationwide Inpatient Sample 2005–2020
title_fullStr Impact of ASD and ADHD on pediatric asthma exacerbations: a retrospective analysis of the Nationwide Inpatient Sample 2005–2020
title_full_unstemmed Impact of ASD and ADHD on pediatric asthma exacerbations: a retrospective analysis of the Nationwide Inpatient Sample 2005–2020
title_short Impact of ASD and ADHD on pediatric asthma exacerbations: a retrospective analysis of the Nationwide Inpatient Sample 2005–2020
title_sort impact of asd and adhd on pediatric asthma exacerbations a retrospective analysis of the nationwide inpatient sample 2005 2020
topic Autism spectrum disorder (ASD)
Attention deficit hyperactivity disorder (ADHD)
Asthma
Children
In-hospital mortality
Complication
url https://doi.org/10.1186/s13052-025-01974-0
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