Visualizing the Comorbidity Burden in Children with Autism Spectrum Disorder Receiving Dental Treatment Under General Anesthesia.
OBJECTIVE
The purposes of this study were to: (1) describe the comorbidity burden in children with autism spectrum disorder (ASD) receiving dental treatment under general anesthesia (GA); and (2) characterize the complexity of these concurrent comorbidities.


METHODS
A retrospective chart review was completed of 303 children with ASD who received dental treatment under GA. All comorbidities, in addition to the primary diagnosis of ASD, were categorized using the International Classification of Diseases-10 codes. The interconnectedness of the comorbidities was graphically displayed using a network plot. Network indices (degree centrality, betweenness centrality, closeness centrality) were used to characterize the comorbidities that exhibited the highest connectedness to ASD.


RESULTS
The network plot of medical diagnoses for children with ASD was highly complex, with multiple connected comorbidities. Developmental delay, speech delay, intellectual disability, and seizure disorders exhibited the highest connectedness to ASD.


CONCLUSIONS
Children with autism spectrum disorder may have a significant comorbidity burden of closely related neurodevelopmental disorders. The medical history review should assess the severity of these concurrent disorders to evaluate a patient's potential ability to cooperate for dental treatment and to determine appropriate behavior guidance techniques to facilitate the delivery of dental care.
Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada. kmmuju@dentistry.ubc.ca.
Kavita R
KR
Mathu-Muju
Center for Outcomes Research and Education, Portland, Ore., USA.
Hsin-Fang
HF
Li
St. Barnabas Hospital, Bronx, N,Y., USA.
Lisa H
LH
Nam
Associate professor, Biostatistics, University of Kentucky, Lexington, Ky., USA.
Heather M
HM
Bush
D000768:Anesthesia, General; D000067877:Autism Spectrum Disorder; D002648:Child; D015897:Comorbidity; D003729:Dental Care; D006801:Humans; D012189:Retrospective Studies