Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark.
Europace. 2018 Sep 1;20(FI2):f192-f197. doi: 10.1093/europace/eux335.
Febrile seizure (FS) is a common disorder affecting 2-5% of children up to 5 years of age. The aim of this study was to determine whether FS in early childhood are over-represented in young adults dying from sudden cardiac death (SCD).
We included all deaths (n = 4595) nationwide and through review of all death certificates, we identified 245 SCD in Danes aged 1-30 years in 2000-09. Through the usage of nationwide registries, we identified all persons admitted with first FS among SCD cases (14/245; 5.7%) and in the corresponding living Danish population (71 027/2 369 785; 3.0%) and also in victims of transport accidents (26/917; 2.8%). The frequency of FS among SCD cases was significantly increased by an odds ratio of 1.96 [95% confidence interval (CI) 1.14-3.36; P = 0.021] compared with the living Danish population and with an odds ratio of 2.08 (95% CI 1.07-4.04; P = 0.046) compared with transport accident victims. SCD cases did not differ statistically in birth year (P = 0.272), age at SCD (P = 0.667) or prior medical conditions, except for epilepsy (P < 0.001), when comparing SCD with and without prior FS. The most common cause of death in autopsied SCD cases with FS was sudden arrhythmic death syndrome (5/8; 62.5%).
In conclusion, this study demonstrates a significantly two-fold increase in the frequency of FS prior to death in young SCD cases compared with the two control groups, suggesting that FS could potentially contribute in a risk stratification model for SCD and warrant further studies.
热性惊厥(FS)是一种常见疾病,影响 2-5%的 5 岁以下儿童。本研究旨在确定幼儿时期的 FS 是否在年轻的心脏性猝死(SCD)患者中更为常见。
我们纳入了全国范围内的所有死亡病例(n=4595),并通过对所有死亡证明的审查,确定了 2000-09 年丹麦 1-30 岁人群中 245 例 SCD。通过使用全国性登记册,我们确定了 SCD 病例中首次 FS 的所有患者(14/245;5.7%),以及相应的丹麦活人群(71027/2369785;3.0%)和交通意外事故受害者(26/917;2.8%)。与丹麦活人群相比,SCD 病例中 FS 的发生频率显著增加,优势比为 1.96(95%置信区间[CI]为 1.14-3.36;P=0.021);与交通意外事故受害者相比,优势比为 2.08(95%CI 为 1.07-4.04;P=0.046)。与交通意外事故受害者相比,SCD 病例在出生年份(P=0.272)、SCD 年龄(P=0.667)或既往医疗条件方面无统计学差异,但癫痫除外(P<0.001)。在有或无 FS 既往史的 SCD 病例中,尸检中最常见的死因是心律失常性猝死综合征(5/8;62.5%)。
总之,本研究表明,与两个对照组相比,年轻 SCD 病例死亡前 FS 的发生频率显著增加了两倍,提示 FS 可能在 SCD 的风险分层模型中发挥作用,值得进一步研究。