title: Unintentional injuries in children with disabilities: a systematic review and meta-analysis.
abstract: Children with disabilities are thought to have an increased risk of unintentional injuries, but quantitative syntheses of findings from previous studies have not been done. We conducted a systematic review and meta-analysis to assess whether pre-existing disability can increase the risk of unintentional injuries among children when they are compared to children without disability. We searched 13 electronic databases to identify original research published between 1 January 1990 and 28 February 2013. We included those studies that reported on unintentional injuries among children with pre-existing disabilities compared with children without disabilities. We conducted quality assessments and then calculated pooled odds ratios of injury using random-effects models. Fifteen eligible studies were included from 24,898 references initially identified, and there was a total sample of 83,286 children with disabilities drawn from the eligible studies. When compared with children without disabilities, the pooled OR of injury was 1.86 (95 % CI 1.65-2.10) in children with disabilities. The pooled ORs of injury were 1.28, 1.75, and 1.86 in the 0-4 years, 5-9 years, and ≥10 years of age subgroups, respectively. Compared with children without disabilities, the pooled OR was 1.75 (95 % CI 1.26-2.43) among those with International Classification of Functioning (ICF) limitations. When disability was defined as physical disabilities, the pooled OR was 2.39 (95 % CI 1.43-4.00), and among those with cognitive disabilities, the pooled OR was 1.77 (95 % CI 1.49-2.11). There was significant heterogeneity in the included studies. Compared with peers without disabilities, children with disabilities are at a significantly higher risk of injury. Teens with disabilities may be an important subgroup for future injury prevention efforts. More data are needed from low- and middle-income countries.
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical College, Zunyi, Guizhou, China.|Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.
authors.forename: Xiuquan
authors.initials: X
authors.lastname: Shi
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.|Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Junxin
authors.initials: J
authors.lastname: Shi
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.|Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Krista K
authors.initials: KK
authors.lastname: Wheeler
authors.affiliation: Colorado Injury Control Research Center, Colorado State University, Fort Collins, Colorado, USA.
authors.forename: Lorann
authors.initials: L
authors.lastname: Stallones
authors.affiliation: Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Shanthi
authors.initials: S
authors.lastname: Ameratunga
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Shakespeare
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.|Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Smith
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA. Huiyun.Xiang@nationwidechildrens.org.|Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA. Huiyun.Xiang@nationwidechildrens.org.|Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA. Huiyun.Xiang@nationwidechildrens.org.
authors.forename: Huiyun
authors.initials: H
authors.lastname: Xiang
keywords: Children; Disability; Injury; Meta-analysis