Huttunen Jukka, Lindgren Antti, Kurki Mitja I, Huttunen Terhi, Frösen Juhana, Koivisto Timo, von Und Zu Fraunberg Mikael, Immonen Arto, Jääskeläinen Juha E, Kälviäinen Reetta
From Neurosurgery (J.H., A.L., M.I.K., T.H., J.F., T.K., M.v.u.z.F., A.I., J.E.J.) and Neurology (R.K.), KUH NeuroCenter, Kuopio University Hospital, and Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio.
Neurology. 2017 Jul 18;89(3):263-268. doi: 10.1212/WNL.0000000000004113. Epub 2017 Jun 14.
To elucidate the epilepsy-associated causes of death and subsequent excess long-term mortality among 12-month survivors of subarachnoid hemorrhage from saccular intracranial aneurysm (SIA-SAH).
The Kuopio SIA Database (kuopioneurosurgery.fi) includes all SIA-SAH patients admitted to the Kuopio University Hospital from its defined catchment population in Eastern Finland. The study cohort consists of 779 patients, admitted from 1995 to 2007, who were alive at 12 months after SIA-SAH. Their use of reimbursable antiepileptic drugs and the causes of death (ICD-10) were fused from the Finnish national registries from 1994 to 2014.
The 779 12-month survivors were followed up until death (n = 197) or December 31, 2014, a median of 12.0 years after SIA-SAH. Epilepsy had been diagnosed in 121 (15%) patients after SIA-SAH, and 34/121 (28%) had died at the end of follow-up, with epilepsy as the immediate cause of death in 7/34 (21%). In the 779 patients alive at 12 months after SIA-SAH, epilepsy was an independent risk factor for mortality (hazard ratio 1.8, 95% confidence interval 1.1-3.0).
Comorbid epilepsy in 12-month survivors of SIA-SAH is associated with increased risk of death in long-term follow-up. Survivors of SIA-SAH require long-term dedicated follow-up, including identification and effective treatment of comorbid epilepsy to prevent avoidable deaths.
阐明颅内囊状动脉瘤蛛网膜下腔出血（SIA-SAH）12个月幸存者中与癫痫相关的死亡原因及随后长期的额外死亡率。
库奥皮奥SIA数据库（kuopioneurosurgery.fi）包含了从芬兰东部特定集水区人口中收治入库奥皮奥大学医院的所有SIA-SAH患者。研究队列由1995年至2007年收治的779例患者组成，这些患者在SIA-SAH后12个月时仍存活。他们从1994年至2014年芬兰国家登记处获取可报销抗癫痫药物的使用情况及死亡原因（国际疾病分类第十版，ICD-10）。
779例12个月幸存者随访至死亡（n = 197）或2014年12月31日，SIA-SAH后中位随访时间为12.0年。121例（15%）患者在SIA-SAH后被诊断为癫痫，其中34/121例（28%）在随访结束时死亡，7/34例（21%）直接死于癫痫。在SIA-SAH后12个月存活的779例患者中，癫痫是死亡的独立危险因素（风险比1.8，95%置信区间1.1 - 3.0）。
SIA-SAH 12个月幸存者中的合并癫痫与长期随访中死亡风险增加相关。SIA-SAH幸存者需要长期的专门随访，包括识别和有效治疗合并癫痫以预防可避免的死亡。
