The George Institute for Global Health, Faculty of Medicine, University of New South Wales, 83-117 Missenden Road, Camperdown, NSW 2050, Australia; School of Public Health, Faculty of Medicine and Health, Edward Ford Building (A27) Fisher Road, University of Sydney, NSW 2006, Australia.
The George Institute for Global Health, Faculty of Medicine, University of New South Wales, 83-117 Missenden Road, Camperdown, NSW 2050, Australia; Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Pudong New District, Shanghai 200127, PR China.
Epilepsy Behav. 2019 May;94:252-257. doi: 10.1016/j.yebeh.2019.03.032. Epub 2019 Apr 9.
Epilepsy influences the ability to drive. We aimed to systematically summarize factors associated with driving, holding a driver's license, and traffic accidents among people with seizures.
Eight databases were searched (from their inception to 27 June 2018). We included all published observational studies, except for case reports and studies with fewer than 50 participants. Pooled mean differences and pooled risk ratios (pRRs) with corresponding confidence intervals (CIs) were calculated using random effects.
Data were available from 18 studies, reporting a wide range of factors. There were frequent biases associated with cross-sectional study designs, selection bias, poor statistical quality, small samples, and lack of validation of models. The following six variables were consistently associated with driving: male gender (pRR: 1.42; 95% CI: 1.23 to 1.64), being in paid work (pRR: 1.72; 95% CI: 1.46 to 2.03), married (pRR: 1.26; 95% CI: 1.01 to 1.57), older age at seizure onset or diagnosis (pooled mean difference: 4.83; 95% CI: 0.48 to 9.18 years), less frequent seizures (fewer than monthly, pRR: 1.32; 95% CI: 1.12 to 1.56), and taking one or no antiepileptic drug (pRR: 1.34; 95% CI: 1.09 to 1.63). Lower seizure frequency was also protective for avoiding traffic accidents (pRR: 0.26; 95% CI: 0.10 to 0.66).
Stable multivariate models to predict driving or traffic accidents among people with seizures have not yet been developed. Current evidence shows that the likelihood of driving is associated with demographic and epilepsy-related factors, while the risk of traffic accidents is associated with seizure frequency.
癫痫会影响驾驶能力。我们旨在系统地总结与癫痫患者驾驶、持有驾照和交通事故相关的因素。
我们检索了 8 个数据库（从其建立到 2018 年 6 月 27 日）。我们纳入了所有已发表的观察性研究，病例报告和参与者少于 50 人的研究除外。使用随机效应计算汇总均数差值和汇总风险比（pRR）及其置信区间（CI）。
有 18 项研究提供了数据，报告了广泛的因素。由于横断面研究设计、选择偏倚、统计质量差、样本量小以及模型验证不足等原因，存在频繁的偏倚。以下六个变量与驾驶密切相关：男性（pRR：1.42；95%CI：1.23 至 1.64）、有薪工作（pRR：1.72；95%CI：1.46 至 2.03）、已婚（pRR：1.26；95%CI：1.01 至 1.57）、癫痫发作或诊断年龄较大（汇总均数差值：4.83；95%CI：0.48 至 9.18 年）、发作频率较低（每月少于一次，pRR：1.32；95%CI：1.12 至 1.56）和服用一种或不服用抗癫痫药物（pRR：1.34；95%CI：1.09 至 1.63）。发作频率较低也可降低发生交通事故的风险（pRR：0.26；95%CI：0.10 至 0.66）。
目前尚未开发出用于预测癫痫患者驾驶或交通事故的稳定多变量模型。现有证据表明，驾驶的可能性与人口统计学和癫痫相关因素有关，而交通事故的风险与发作频率有关。
