MORTALITY FROM EPILEPSY - RESULTS FROM A PROSPECTIVE POPULATION-BASED STUDY
MORTALITY FROM EPILEPSY - RESULTS FROM A PROSPECTIVE POPULATION-BASED STUDY
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DOI：
10.1016/s0140-6736(94)92270-5
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发表时间：
1994-10-01
期刊：
影响因子：
168.9
通讯作者：
SHORVON, SD
中科院分区：
文献类型：
--
作者：
COCKERELL, OC;JOHNSON, AL;SHORVON, SD
癫痫患者可能会因根本原因或癫痫本身而过早死亡的风险增加。这种风险的程度和性质还没有得到充分的调查。新诊断的癫痫患者的标准死亡率(SMR)是在一项基于人群的前瞻性研究中确定的。1987.1091例确诊为癫痫患者，6个月后分为确定癫痫5 6 4例，可能癫痫2 2 8例，热性癫痫2 2 0例，暴发性癫痫79例。中位随访6.9年，确诊或可能癫痫患者的SMR为2.5(95%CI 2.1~2.9)，明确癫痫患者SMR为3.0(2.5~3.7)。SMR在确诊后第1年最高5.1(3.8~6.5)，3年降至2.5(1.5~3.9)，5年降至1.3(0.7~2.0)。最常见的死亡原因是肺炎(SMR 7.2)、癌症(3.5)和中风(3.7)。特发性癫痫的SMR为1.6(1.0~2.4)，远期症状性癫痫为4.3(3.3~5.5)，急性症状性癫痫为2.9(1.7~4.5)。特发性癫痫的SMR也提高了，这表明癫痫本身可能带有很小的死亡风险。
Patients with epilepsy may be subject to an increased risk of premature death from the underlying cause, or from the epilepsy intself. The extent and nature of this risk has been insufficiently investigated. Standard mortality ratios (SMRs) of patients with newly diagnosed epilepsy were determined in a prospective national population-based study. 1091 patients with newly diagnosed pr suspected epilepsy were ascertained who were attending one of 275 UK general practices from 1984-1987.1091 patients were classified after 6 months as definite epilepsy (564), possible epilepsy (228), febrile seizures (220), or riot epilepsy (79). Over a median follow up of 6.9 years the SMR for patients with definite or possible epilepsy was 2.5 (95% Cl 2.1-2.9), and 3.0 (2.5-3.7) for definite epilepsy. The SMR was highest during the first year after diagnosis 5.1 (3.8-6.5), declined to 2.5 (1.5-3.9) at 3 years, and 1.3 (0.7-2.0) at 5 years. The commonest causes of death were pneumonia (SMR 7.2), cancer (3.5), and stroke (3.7). The SMR for patients with idiopathic epilepsy was 1.6 (1.0-2.4), remote symptomatic epilepsy 4.3 (3.3-5.5), and acute symptomatic epilepsy 2.9 (1.7-4.5).Mortality in patients with newly-diagnosed epilepsy was high, mainly due to the underlying cause. The SMR for idiopathic epilepsy was also raised, suggesting that epilepsy per se may carry a small risk of death.