Maqbool Umar, Saleem Maleeha, Khan Fareeha, Assad Arfa Ahmed, Rehman Haram, Abdul Ghaffar Qais Bin, Alamgir Unsa, Alamgir Iqra, Saleem Maria, Alamgir Eman, Adeel Ammad, Syed Muhammad Rayan, Saad Muhammad
King Edward Medical University, Lahore, Pakistan.
West Suffolk Hospital, Bury St Edmunds, England, United Kingdom.
J Clin Neurosci. 2025 Jun 17;138:111396. doi: 10.1016/j.jocn.2025.111396.
Epilepsy affects millions of people in the US annually, leading to disability and death. This study aims to comprehensively delve into the epidemiological framework of epilepsy-related mortality by stratification of data through gender, ethnicity, and geographical regions over two decades, as these have not been done previously to this extent, with a view to addressing the target population precisely.
This retrospective study analyzed epilepsy-related mortality data in the United States from the CDC (Centers for Disease Control and Prevention) database of all age groups using ICD-10 codes of G40.0 to G40.9 from 1999 to 2020. Age-adjusted Mortality rates (AAMRs) per 100,000 persons were calculated and categorized by year, sex, race/ethnicity, place of death, and geographic location. The Joinpoint regression analyzed these AAMRs to produce annual percent changes (APCs) to assess mortality trend changes.
A total of 57,304 Epilepsy related deaths occurred between 1999 and 2020 in the United States. The overall AAMR for epilepsy in 1999 was 0.6 (95 % CI, 0.5 to 0.6) and increased to 1.64 (95 % CI, 1.59 to 1.68) in 2020. Men exhibited a higher AAMR than females throughout the study period from 1999 (0.7 vs. 0.47) to 202O (1.84 vs. 1.46); a significant rise was seen in APC for both genders in the second decade, i.e., 2010 to 2020. The highest mortality was noted in Non-Hispanic (NH) black or African Americans (AAMR:1.38), followed by NH American Indian or Alaskan Natives (AAMR:1.07), NH White (AAMR:0.76), Hispanics or Latinos (AAMR:0.76), and NH Asian or Pacific Islanders (AAMR:0.32). Regional analysis showed disparities in AAMR, the West being most prominent with an AAMR reported to be 1.04, followed by the Midwest regions (AAMR: 0.88), the South regions (AAMR: 0.77), and the Northeast regions (AAMR: 0.53). The states with AAMRs in the top 90th percentile included Iowa, Mississippi, Colorado, South Dakota, and Michigan, with non-metropolitan regions having higher AAMRs (0.92) than metropolitan counterparts (0.76).
The findings of our study emphasize the critical importance of addressing the rise in mortality, especially in the second decade, by devising strategies and policies targeting at-risk populations and improving the management framework for such patients, with more widespread public awareness regarding the disease and its risk factors.
癫痫每年影响美国数百万人，导致残疾和死亡。本研究旨在通过对二十年间按性别、种族和地理区域进行数据分层，全面深入地探究癫痫相关死亡率的流行病学框架，因为此前尚未在如此程度上进行过此类研究，以期精准定位目标人群。
这项回顾性研究分析了美国疾病控制与预防中心（CDC）数据库中1999年至2020年所有年龄组使用ICD - 10编码G40.0至G40.9的癫痫相关死亡率数据。计算了每10万人的年龄调整死亡率（AAMR），并按年份、性别、种族/民族、死亡地点和地理位置进行分类。Joinpoint回归分析这些AAMR以产生年度百分比变化（APC），以评估死亡率趋势变化。
1999年至2020年期间，美国共发生57304例癫痫相关死亡。1999年癫痫的总体AAMR为0.6（95%置信区间，0.5至0.6），到2020年增至1.64（95%置信区间，1.59至1.68）。在整个研究期间，从1999年（0.7对0.47）到2020年（1.84对1.46），男性的AAMR高于女性；在第二个十年，即2010年至2020年，两性的APC均显著上升。死亡率最高的是非西班牙裔（NH）黑人或非裔美国人（AAMR：1.38），其次是NH美洲印第安人或阿拉斯加原住民（AAMR：1.07）、NH白人（AAMR：0.76）、西班牙裔或拉丁裔（AAMR：0.76）以及NH亚裔或太平洋岛民（AAMR：0.32）。区域分析显示AAMR存在差异，西部最为突出，报告的AAMR为1.04，其次是中西部地区（AAMR：0.88）、南部地区（AAMR：0.77）和东北地区（AAMR：0.53）。AAMR处于第90百分位以上的州包括爱荷华州、密西西比州、科罗拉多州、南达科他州和密歇根州，非大都市地区的AAMR（0.92）高于大都市地区（0.76）。
我们的研究结果强调了应对死亡率上升的至关重要性，特别是在第二个十年，要通过制定针对高危人群的策略和政策，改善此类患者的管理框架，并提高公众对该疾病及其风险因素的广泛认识。
