Premature mortality risk in people with convulsive epilepsy: Long follow‐up of a cohort in rural China

作者：Ding Ding, Wenzhi Wang, Jianzhong Wu, Hongchao Yang, Shichuo Li, Xiuying Dai, Bin Yang, Taiping Wang, Chenglin Yuan, Guangyu Ma, Gail S. Bell, Patrick Kwan, Hanneke M. de Boer, Zhen Hong, Josemir W. A. S. Sander · 发表于：Epilepsia · 年份：2012 · DOI：10.1111/epi.12048 · 被引用次数：96 · 研究领域：Epilepsy research and treatment、Pharmacological Effects and Toxicity Studies、Psychosomatic Disorders and Their Treatments

PURPOSE: Detailed data on the mortality of epilepsy are still lacking from resource-poor settings. We conducted a long-term follow-up survey in a cohort of people with convulsive epilepsy in rural areas of China. In this longitudinal prospective study we investigated the causes of death and premature mortality risk among people with epilepsy. METHODS: We attempted to trace all 2,455 people who had previously participated in a pragmatic assessment of epilepsy management at the primary health level. Putative causes of death were recorded for those who died, according to the International Classification of Diseases. We estimated proportional mortality ratios (PMRs) for each cause, and standardized mortality ratios (SMRs) for each age-group and cause. Survival analysis was used to detect risk factors associated with increased mortality. KEY FINDINGS: During 6.1 years of follow-up there were 206 reported deaths among the 1,986 people with epilepsy who were located. The highest PMRs were for cerebrovascular disease (15%), drowning (14%), self-inflicted injury (13%), and status epilepticus (6%), with probable sudden unexpected death in epilepsy (SUDEP) in 1%. The risk of premature death was 2.9 times greater in people with epilepsy than in the general population. A much higher risk (SMRs 28-37) was found in young people. Duration of epilepsy and living in a waterside area were independent predictors for drowning. SIGNIFICANCE: Drowning and status epilepticus were important, possibly...