Title

Impact of Stimulants to Reduce Readmission for Aggressive Behavior in Children with Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder

Division

East Florida

Hospital

Aventura Hospital and Medical Center

Document Type

Manuscript

Publication Date

Spring 2021

Keywords

autism spectrum disorder, attention deficit disorder with hyperactivity, aggression, central nervous system stimulants, patient readmission

Disciplines

Mental Disorders | Psychiatry | Psychiatry and Psychology

Abstract

Background Disruptive and aggressive behavior are some of the more common reasons for admission among pediatric patients with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). These patients require more physician visits than their peers. Stimulants are medications shown to be effective in both ADHD and ASD. The goal of the authors is to estimate the strength of association between the use of stimulants during hospitalization and reduction of 30- and 90-day readmission rates for aggressive behavior.

Methods This is a retrospective study examining encounters made at 65 HCA hospitals within the United States (U.S.) from 2016 to 2019. Main exposure was the presence of stimulants at any dose during hospitalization. Main outcome was defined as 30- and 90-day readmissions and length of stay. Controlled variables include sex, age, and ethnicity.

Results 423 patients ages 4 to 17 were admitted for aggressive behavior and carried a diagnosis of ADHD and ASD. Only 97 patients (23%) received stimulants during hospitalization. Presence of stimulants was associated with decreased rates of 30-day and 90-day readmission with odds ratio of 0.224 and 0.238 respectively (p<0.05).

Conclusions Stimulants given for patients with ADHD as well as ASD were found to be associated with a decrease in the likelihood of readmission to the hospital for aggressive behavior within 30- and 90-day intervals. Future studies should determine whether the reduction in hospitalization is linked with improved long-term care as well as decreased cost of hospitalization for these patients.

Publisher or Conference

Miami Medicine

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