Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Epilepsia. 2010 Nov;51(11):2247-53. doi: 10.1111/j.1528-1167.2010.02697.x. Epub 2010 Aug 17.
To compare the 1-year population-based incidence and types of injuries in persons with and without epilepsy.
Three administrative databases (inpatient visits, physician claims, and emergency room visits) were linked from fiscal years 1996-2003 using a provincial insurance plan registry, which captures 99% of a population of 1.4 million in a large Canadian health region. Epilepsy cases (all age groups) from fiscal year 1996-2002 were identified. Three people without epilepsy were matched to one person with epilepsy for age (±1 year) and sex. Injuries were defined as any of 16 types of injuries for which medical attention was sought that occurred within fiscal year 2003.
Eight thousand eight hundred ninety subjects with epilepsy were identified and matched to 26,670 controls for age and sex. The mean age was 37.4 years (range 0.01-96.4 years), and 51.3% of subjects were male. The 1-year incidence of one or more injuries was 20.6% among persons with epilepsy and 16.1% among those without epilepsy (p < 0.001). Of the 16 types of injuries studied, 11 were higher in persons with epilepsy compared to those without epilepsy, and included fractures, crushing injuries, intracranial injuries, other types of head injuries, and multiple injuries. The difference was still significant after adjusting for age, gender, and comorbidities.
The 1-year incidence of injuries in this study was greater in persons with epilepsy compared to those without epilepsy, for nearly all injury types. Injury prevention should be discussed during routine visits in persons with epilepsy.
比较有和无癫痫患者的 1 年人群发生率和损伤类型。
使用省级保险计划登记册将 1996 年至 2003 年的三个行政数据库(住院患者就诊、医生索赔和急诊就诊)进行链接,该登记册覆盖了一个 140 万人口的大型加拿大卫生区的 99%的人群。从 1996 年至 2002 年财政年度确定癫痫病例(所有年龄组)。为每个癫痫患者匹配 3 名无癫痫的对照者,匹配年龄(±1 岁)和性别。损伤定义为在 2003 年财政年度内寻求医疗注意的任何 16 种损伤类型之一。
确定了 8890 名癫痫患者,并将他们的年龄和性别与 26670 名对照者相匹配。平均年龄为 37.4 岁(范围为 0.01-96.4 岁),51.3%的患者为男性。癫痫患者的 1 年损伤发生率为 20.6%,无癫痫患者的发生率为 16.1%(p<0.001)。在所研究的 16 种损伤类型中,有 11 种在癫痫患者中高于无癫痫患者,包括骨折、挤压伤、颅内损伤、其他类型的头部损伤和多发性损伤。在调整年龄、性别和合并症后,差异仍然显著。
与无癫痫患者相比,该研究中癫痫患者的 1 年损伤发生率更高,几乎所有损伤类型均如此。在癫痫患者的常规就诊中应讨论损伤预防。