MMWR Morb Mortal Wkly Rep. 2014 Nov 7;63(44):989-94.
Epilepsy is a common childhood neurologic disorder. In 2007, epilepsy affected an estimated 450,000 children aged 0-17 years in the United States. Approximately 53% of children with epilepsy and special health care needs have co-occurring conditions, and only about one third have access to comprehensive care. The few studies of mortality risk among children with epilepsy as compared with the general population generally find a higher risk for death among children with epilepsy with co-occurring conditions but a similar risk for death among children with epilepsy with no co-occurring conditions. However, samples from these mortality studies are often small, limiting comparisons, and are not representative. This highlights the need for expanded mortality surveillance among children with epilepsy to better understand their excess mortality. This report describes mortality among children with epilepsy in South Carolina during 2000-2011 by demographic characteristics and underlying causes of death. The overall mortality rate among children with epilepsy was 8.8 deaths per 1,000 person-years, and the annual risk for death was 0.84%. Developmental conditions, cardiovascular disorders, and injuries were the most common causes of death among children with epilepsy. Team-based care coordination across medical and nonmedical systems can improve outcomes and reduce health care costs for children with special health care needs, but they require more study among children with epilepsy. Ensuring appropriate and timely health care and social services for children with epilepsy, especially those with complications, might reduce the risk for premature death. Health care providers, social service providers, advocacy groups and others can work together to assess whether coordinated care can improve outcomes for children with epilepsy.
癫痫是一种常见的儿童神经系统疾病。2007 年，美国约有 45 万名 0-17 岁的儿童患有癫痫。大约 53%患有癫痫和特殊医疗需求的儿童同时患有其他疾病，只有约三分之一的儿童能够获得全面的治疗。少数关于癫痫儿童与普通人群死亡率风险的研究一般发现，同时患有其他疾病的癫痫儿童的死亡风险较高，但没有其他疾病的癫痫儿童的死亡风险相似。然而，这些死亡率研究的样本往往较小，限制了比较，并且不具有代表性。这突出表明需要扩大对癫痫儿童的死亡率监测，以更好地了解他们的超额死亡率。本报告描述了 2000-2011 年南卡罗来纳州癫痫儿童的死亡率，按人口统计学特征和死亡的根本原因进行分类。癫痫儿童的总体死亡率为每 1000 人年 8.8 人死亡，年死亡风险为 0.84%。发育障碍、心血管疾病和伤害是癫痫儿童死亡的最常见原因。医疗和非医疗系统之间的团队式医疗协调可以改善有特殊医疗需求的儿童的治疗效果并降低医疗成本，但它们需要在癫痫儿童中进行更多的研究。确保癫痫儿童，尤其是那些有并发症的儿童，能够获得适当和及时的医疗和社会服务，可能会降低其过早死亡的风险。医疗保健提供者、社会服务提供者、倡导团体和其他各方可以共同努力，评估协调护理是否可以改善癫痫儿童的治疗效果。
