The incidence of epilepsy and unprovoked seizures in multiethnic, urban health maintenance organizations
The incidence of epilepsy and unprovoked seizures in multiethnic, urban health maintenance organizations
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DOI：
10.1111/j.1528-1157.1999.tb00748.x
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发表时间：
1999-04-01
期刊：
影响因子：
5.6
通讯作者：
Roht, L
中科院分区：
文献类型：
--
作者：
Annegers, JF;Dubinsky, S;Roht, L
目的：对癫痫发病率的研究仅限于可以确定新病例的少数人群。对健康维护组织 (HmO) 人群进行了研究，以确定美国城市多种族人群的发病率。方法：确定 1988 年至 1994 年间参加 HMO 期间首次无端癫痫发作或癫痫的病例。种族是从医疗记录中获得的，并且是巢式病例对照研究的一部分。结果：共有 197 例癫痫发病病例和 275 例初始无端癫痫发作诊断。 0-64岁年龄段的癫痫发病率为每10万人中35.5例，初次无端癫痫发作率为50.9例。与基于人群的研究相比，15 岁以下儿童的发病率略高，与 15 至 24 岁年龄组相似，但 25-64 岁儿童的发病率较低。以非西班牙裔白人为参照物，初次无端癫痫发作的种族特异性比值比为：非裔美国人为 1.04 (0.73-1.39)，西班牙裔为 0.97 (0.64-1.48)，亚裔美国人为 0.25 (0.08-0.84)。 结论：HMO 人群中较低的发病率可能是由于健康工人效应。该人群中不同种族的发病率没有差异。
Purpose: Studies of the incidence of epilepsy are limited to a few populations in which new cases can be ascertained. Health maintenance organization (HmO) populations were studied to determine the incidence in a multiethnic, urban United States population.Method's: Cases of initial unprovoked seizure disorder or epilepsy while enrolled in an HMO between 1988 and 1994 were ascertained. Ethnicity was obtained from the medical records and was part of a nested case-control study.Results: There were 197 incidence cases of epilepsy and 275 of initial unprovoked seizure diagnosis. The incidence rate in the age range 0-64 years was 35.5 per 100,000 for epilepsy and 50.9 for initial unprovoked seizure. When compared with population-based studies, rates were slightly higher in children younger than 15, similar for the 15- to 24-year age group, but lower for ages 25-64 years. The ethnicity-specific odds ratios for initial unprovoked seizure, by using non-Hispanic white as the referent,were 1.04 (0.73-1.39) for African-American, 0.97 (0.64-1.48) for Hispanic, and 0.25 (0.08-0.84) for Asian-American.Conclusions: The lower rate in the HMO population is presumably due to a healthy-worker effect. The ethnicity-specific incidence rates do not differ in this population.