Cause‐Specific Mortality in Epilepsy: A Cohort Study of More Than 9,000 Patients Once Hospitalized for Epilepsy

Epilepsia - Tập 38 Số 10 - Trang 1062-1068 - 1997
Lena Nilsson1, Torbjörn Tomson2, Bahman Farahmand3, Vinod Diwan4, P Persson3
1Department of Neurological Rehabilitation, Stora Sköndal Hospital, Stockholm, Sweden.
2Department of Clinical Neuroscience, Division of Neurology, Karolinska Hospital, Karolinska Institutet, Epidemiologic Unit, Stockholm County Council, Stockholm, Sweden
3Institute of Environmental Medicine, Karolinska Institutet, Epidemiologic Unit, Stockholm County Council, Karolinska Institute, Stockholm, Sweden
4Department of International Health and Social Medicine, Unit of International Health, Karolinska Institute, Stockholm, Sweden

Tóm tắt

Summary: Purpose: We studied overall and cause‐specific mortality rates in a large cohort of patients with epilepsy compared with mortality rates of the general population in the same geographic area. Methods: The cohort consisted of all patients (N = 9,061) aged >15 years admitted with a diagnosis of epilepsy for inpatient care in Stockholm during the years 1980–1989. All patients were followed in the National Cause‐of‐Death Register, from which the causes of death were obtained, until December 31, 1992. Thus, 53,520 person‐years were observed. Mortality rates were compared with those of the general population of Stockholm. Results: We observed 4,001 deaths in the cohort, compared with an expected number of 1,109 deaths in the general population. This yielded a standardized mortality ratio (SMR) of 3.6 [95% confidence interval (CI) 3.5–3.71] Although highest in the younger patients, the SMR was significantly increased in all age groups. The excess mortality rate in the cohort was due to a wide range of causes of death, including malignant neoplasms [SMR 2.6 (2.4–2.8)], diseases of the circulatory system, [SMR 3.1 (3.0–3.3)], diseases of the respiratory system [SMR 4.0 (3.64.5)], diseases of the digestive system [SMR 5.1 (4.4–5.8)], and injuries and poisoning [SMR 5.6 (5.0–6.3)]. Conclusions: Our results demonstrate that this large subgroup of patients with a diagnosis of epilepsy, once hospitalized and discharged, is a population at risk, with an excess mortality rate due to several different causes.

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Epilepsia

Tập 38 Số 10

1062-1068

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