University of Nottingham, Nottingham, England; and
University of Nottingham, Nottingham, England; and.
Pediatrics. 2014 May;133(5):827-35. doi: 10.1542/peds.2013-2554. Epub 2014 Apr 14.
To investigate whether children and young adults with epilepsy are at a greater risk of fracture, thermal injury, or poisoning than those without.
A cohort study was conducted by using the Clinical Practice Research Datalink (1987-2009), a longitudinal database containing primary care records. A total of 11 934 people with epilepsy and 46 598 without, aged between 1 and 24 years at diagnosis, were followed for a median (interquartile range) of 2.6 (0.8-5.9) years. The risk of fractures (including long bone fractures), thermal injuries, and poisonings (including medicinal and nonmedicinal poisonings) was estimated.
Adjusting for age, gender, Strategic Health Authority region, deprivation, and calendar year at study entry (and, for medicinal poisonings, behavior disorder), people with epilepsy had an 18% increase in risk of fracture (hazard ratio [HR] = 1.18; 95% confidence interval [CI], 1.09-1.27), a 23% increase in risk of long bone fracture (HR = 1.23; 95% CI, 1.10-1.38), a 49% increase in risk of thermal injury (HR = 1.49; 95% CI, 1.27-1.75), and more than twice the risk of poisoning (HR = 2.47; 95% CI, 2.15-2.84), which was limited to poisoning from medicinal products (medicinal HR = 2.54; 95% CI, 2.16-2.99; nonmedicinal HR = 0.96; 95% CI, 0.61-1.52).
Children and young adults with epilepsy are at a greater risk of fracture, thermal injury, and poisoning than those without. The greatest risk is from medicinal poisonings. Doctors and other health care professionals should provide injury and poison prevention advice at diagnosis and epilepsy reviews.
研究癫痫患儿和青少年骨折、热损伤或中毒的风险是否高于无癫痫者。
采用临床实践研究数据库（1987-2009 年）进行队列研究，该数据库为包含初级保健记录的纵向数据库。共纳入 11934 例癫痫患者和 46598 例无癫痫患者，诊断时年龄 1-24 岁，中位（四分位间距）随访 2.6（0.8-5.9）年。估计骨折（包括长骨骨折）、热损伤和中毒（包括药物和非药物中毒）的风险。
在校正年龄、性别、战略卫生机构区域、贫困和研究开始时的日历年后（以及药物中毒的行为障碍），癫痫患者骨折风险增加 18%（风险比[HR] = 1.18；95%置信区间[CI]，1.09-1.27），长骨骨折风险增加 23%（HR = 1.23；95% CI，1.10-1.38），热损伤风险增加 49%（HR = 1.49；95% CI，1.27-1.75），中毒风险增加两倍以上（HR = 2.47；95% CI，2.15-2.84），仅限于药物中毒（药物 HR = 2.54；95% CI，2.16-2.99；非药物 HR = 0.96；95% CI，0.61-1.52）。
癫痫患儿和青少年骨折、热损伤和中毒的风险高于无癫痫者。最大的风险来自药物中毒。医生和其他卫生保健专业人员应在诊断和癫痫复查时提供损伤和中毒预防建议。
