Mortality in Epilepsy.
Mortality in Epilepsy.
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DOI：
10.1046/j.1535-7597.2001.00007.x
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发表时间：
2001-09-01
影响因子：
3.6
通讯作者：
Berg, Anne
中科院分区：
文献类型：
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作者：
Berg, Anne
目的：了解癫痫猝死（SUDEP）的发生率及危险因素。方法：三个癫痫中心招募了4578名患者，并对这些患者进行了为期16463患者年的前瞻性随访。每年对该队列进行死亡筛查。对死亡病例进行调查以确定是否发生猝死。比较在同一中心同时入组的SUDEP病例和对照组的潜在危险因素。结果：SUDEP的发病率为1.21/ 1000患者年，女性（1.45/ 1000）高于男性（0.98/ 1000）。猝死症占所有死亡人数的18%。强直-阵挛性发作的发生、服用两种以上抗惊厥药物、全面智商低于70是发生SUDEP的独立危险因素。强直阵挛发作的次数仅在女性中是一个危险因素。在该队列中，脑结构病变的存在和最后一次就诊时使用精神药物不是SUDEP的危险因素。最后一次就诊时亚治疗抗惊厥药水平在两组中同样普遍。没有特定的抗惊厥药与SUDEP相关。结论：这些结果支持强直阵挛性发作是SUDEP的重要近因的观点。这些信息创建了猝死的风险概况，可能有助于直接预防工作。
OBJECTIVE: To determine incidence of and risk factors for sudden unexpected death in epilepsy (SUDEP).METHODS: Three epilepsy centers enrolled 4,578 patients and prospectively followed these patients for 16,463 patient-years. The cohort was screened for death annually. Deaths were investigated to determine whether SUDEP occurred. Potential risk factors were compared in SUDEP cases and in controls enrolled contemporaneously at the same center.RESULTS: Incidence of SUDEP was 1.21/1,000 patient-years and was higher among women (1.45/1,000) than men (0.98/1,000). SUDEP accounted for 18% of all deaths. Occurrence of tonic-clonic seizures, treatment with more than two anticonvulsant medications, and full-scale IQ less than 70 were independent risk factors for SUDEP. The number of tonic-clonic seizures was a risk factor only in women. The presence of cerebral structural lesions and use of psychotropic drugs at the last visit were not risk factors for SUDEP in this cohort. Sub-therapeutic anticonvulsant levels at the last visit were equally common in the two groups. No particular anticonvulsant appeared to be associated with SUDEP. CONCLUSIONS: These results support the idea that tonic-clonic seizures are an important proximate cause of SUDEP. This information creates a risk profile for SUDEP that may help direct preventative efforts.