Klenerman P, Sander J W, Shorvon S D
Epilepsy Research Group, Chalfont Centre for Epilepsy, Gerrards Cross, London, UK.
J Neurol Neurosurg Psychiatry. 1993 Feb;56(2):149-52. doi: 10.1136/jnnp.56.2.149.
The causes of death in a group of patients with severe epilepsy in long term residential care over a period of 11 years were assessed and the standardised mortality rate (SMR) determined. A total of 3392 patient-years were surveyed. One hundred and thirteen deaths were recorded in the period and this represents an overall mortality rate which is almost twice the expected rate for this population (SMR = 1.9; 95% CI 1.6-2.3; p < 0.01). Most deaths were due to cancer (26%), bronchopneumonia (25%), circulatory diseases (24%), were seizure-related (12%) or due to sudden unexpected death (6%). The highest SMRs in the neoplasm sub-group were due to cancers of the pancreas (SMR = 6.2) and hepatobiliary tumours (SMR = 17.6). Twenty per cent of patients died of epilepsy or epilepsy related causes (that is accidents, during seizures, status or sudden unexpected death). One in every 480 patients died due to a sudden unexpected death. This study in a highly selected population seems to confirm suggestions that mortality rates are higher in patients with epilepsy than in the general population, but prospective studies are warranted to ascertain underlying mechanisms.
对一组长期住院护理的重症癫痫患者在11年期间的死因进行了评估，并确定了标准化死亡率（SMR）。共调查了3392患者年。在此期间记录了113例死亡，这代表的总体死亡率几乎是该人群预期死亡率的两倍（SMR = 1.9；95%可信区间1.6 - 2.3；p < 0.01）。大多数死亡原因是癌症（26%）、支气管肺炎（25%）、循环系统疾病（24%）、与癫痫发作相关（12%）或猝死（6%）。肿瘤亚组中最高的标准化死亡率是由于胰腺癌（SMR = 6.2）和肝胆肿瘤（SMR = 17.6）。20%的患者死于癫痫或与癫痫相关的原因（即事故、癫痫发作期间、癫痫持续状态或猝死）。每480名患者中有1人死于猝死。这项在高度特定人群中的研究似乎证实了癫痫患者死亡率高于一般人群的观点，但仍需要前瞻性研究来确定潜在机制。
