MORTALITY IN PATIENTS WITH EPILEPSY
MORTALITY IN PATIENTS WITH EPILEPSY
复制标题
DOI：
10.1111/j.1528-1157.1980.tb04088.x
复制
发表时间：
1980-01-01
期刊：
影响因子：
5.6
通讯作者：
ELVEBACK, LR
中科院分区：
文献类型：
--
作者：
HAUSER, WA;ANNEGERS, JF;ELVEBACK, LR
1935至1974年间，对明尼苏达州罗切斯特市的一组首次诊断为癫痫的患者进行了标准化死亡率(SMR)测定。整个组的SMR为2.3到29年。特发性癫痫患者的SMR较低，但显著高于预期。有几组特发性癫痫患者的死亡率没有显著升高，包括失神发作、部分和复杂发作、1至19岁之间首次诊断为癫痫的患者或女性患者。高热性惊厥患者的预期死亡率没有变化。单发特发性全身性癫痫的患者死亡率增加。对于整个组和所有特发性病例，SMR最显著的增加发生在确诊后的前10年。SMR间期在诊断后25-29年间显著增加。这表明与癫痫易感性有关的迟发效应，与用于治疗的慢性药物或两者的组合有关。癫痫缓解的患者表现出SMR增加，表明癫痫发生以外的因素影响死亡率。虽然观察到与肺部事件、意外事故、颅外肿瘤和非脑血管或非心血管疾病有关的死亡人数过多，但考虑到这项研究的人-年经验，这些通常具有边缘意义；在研究组中没有唯一的死亡原因。
Standardized mortality ratios (SMR) were determined for a cohort of patients with 1st diagnosis of epilepsy as residents of Rochester, Minnesota [USA], between 1935 and 1974. SMR for the total group was 2.3 through 29 yr of follow-up. SMR was lower for those with idiopathic epilepsy, but was significantly increased from expected. Several groups with idiopathic epilepsy did not have significantly elevated mortality rates, including patients with absence seizures, partial and complex seizures, 1st diagnosis of epilepsy between ages 1 and 19 or patients who were female. Patients with febrile convulsions did not demonstrate alterations in expected mortality. Patients with single idiopathic generalized seizures had an increase in mortality. For the group as a whole and all idiopathic cases, the most significant increase in SMR occurred in the first 10 yr following diagnosis. Interval SMR were significantly increased between 25 and 29 yr following diagnosis. This suggests a late effect associated with predisposition for seizures, an effect related to the chronic medication used for therapy or a combination of the 2. Patients experiencing remission of seizures demonstrated an increase in SMR, suggesting that factors other than seizure occurrence affect mortality. While an excess number of deaths relating to pulmonary events, accidents, extracranial neoplasms and noncerebral or noncardiac vascular disease were observed, given the person-years of experience in this study, these generally were of borderline significance; there was no unique cause of death in the study group.