Chamorro-Muñoz María Isabel, García-Martín Guillermina, Pérez-Errazquin Francisco, Romero-Acebal Manuel, García-Rodríguez Antonio, Gutiérrez-Bedmar Mario
Epilepsy Unit, Department of Neurology, Virgen de la Victoria University Hospital, Málaga, Spain.
Epilepsy Unit, Department of Neurology, Virgen de la Victoria University Hospital, Málaga, Spain.
Seizure. 2017 Mar;46:19-23. doi: 10.1016/j.seizure.2017.02.004. Epub 2017 Feb 8.
Studies concerning mortality in epilepsy have been performed primarily in Northern-Central Europe and US. The aim of this study was to provide information about mortality in people with epilepsy in Southern European countries.
We studied a Spanish prevalence and incidence cohort of 2309 patients aged ≥14 years with epilepsy who were treated in an outpatient epilepsy clinic between 2000 and 2013. The deceased were identified through Civil Registries. Causes of death were determined using death certificates, forensic autopsies, hospital reports, family practitioners, and care-givers' records. Standardised mortality ratios (SMRs) were calculated.
In a total of 15,865 person-years of follow-up, 152 patients died, resulting in an SMR of 2.11 (95% CI 1.79-2.47), which was higher for those aged 14-24. There was also a high rate of death for symptomatic epilepsies, progressive causes (SMR=6.12, CI 3.50-9.94), and remote causes (SMR=2.62, CI 2.12-3.21). High SMRs were found for all kinds of epilepsy and for respiratory and tumoural causes. Patients who died of epilepsy itself were 12.5%. Sudden unexpected death in epilepsy incidence was 0.44:1000. Death from status epilepticus incidence was 20:100,000. SMRs for external causes were of no statistical significance.
This is the first epidemiological study to examine rate of mortality in epilepsy in a Southern European country. The identified mortality pattern is similar to the one provided by researchers from developed countries. The similarities between our results concerning epilepsy-related deaths and those provided by population-based studies are the result of the scarcely selected character of our study cohort.
关于癫痫死亡率的研究主要在北欧、中欧和美国开展。本研究旨在提供有关南欧国家癫痫患者死亡率的信息。
我们研究了一个西班牙的患病率和发病率队列，该队列由2309名年龄≥14岁的癫痫患者组成，他们于2000年至2013年期间在一家门诊癫痫诊所接受治疗。通过民事登记处确定死者身份。使用死亡证明、法医尸检、医院报告、家庭医生和护理人员记录来确定死因。计算标准化死亡率（SMR）。
在总共15865人年的随访中，152名患者死亡，标准化死亡率为2.11（95%置信区间1.79 - 2.47），14 - 24岁人群的标准化死亡率更高。症状性癫痫、进行性病因（标准化死亡率 = 6.12，置信区间3.50 - 9.94）和远期病因（标准化死亡率 = 2.62，置信区间2.12 - 3.21）的死亡率也很高。各类癫痫以及呼吸和肿瘤病因的标准化死亡率都很高。死于癫痫本身的患者占12.5%。癫痫猝死发生率为0.44:1000。癫痫持续状态死亡率为20:100000。外部病因的标准化死亡率无统计学意义。
这是第一项研究南欧国家癫痫死亡率的流行病学研究。所确定的死亡率模式与发达国家研究人员提供的模式相似。我们关于癫痫相关死亡结果与基于人群研究结果之间的相似性是我们研究队列选择特征有限的结果。
