Association Between Epilepsy and Mortality Risk

Pavankumar Kamat

Disclosures

November 05, 2021

Takeaway

  • A study found that the risk of mortality was higher in people with epilepsy (PWE).

  • Emergency department attendance and admissions, anti-epileptic drug (AED) polytherapy, status epilepticus, depression and injuries were risk factors associated with an increased risk of mortality.

Why this matters

  • Findings warrant future studies to identify PWE at high risk and treat them with clinical interventions or better self-management.

  • Identifying specific risk factors for younger people should be a priority.

Study design

  • UK researchers performed a retrospective cohort study to analyse mortality and cause of mortality and a nested case-control study to determine risk factors associated with mortality using data from the UK Clinical Practice Research Datalink.

  • A total of 70,431 PWE with 11,241 registered deaths were included.

  • Funding: Sudden unexpected death in epilepsy Action.

Key results

  • The number of deaths recorded within the database increased by 69% between 2005 and 2013.

  • Epilepsy was a contributing cause in ~45% of deaths of PWE aged <35 years.

  • Factors associated with an increased risk of mortality in PWE were (OR; 95% CI):

    • attendance at emergency departments and admissions (3.48; 3.19-3.80);

    • AED polytherapy:

      • 2 AEDs (1.60; 1.51-1.71);

      • 3 AEDs (2.06; 1.86-2.29); and

      • 4+ AEDs (2.62; 2.23-3.08).

    • status epilepticus (2.78; 1.64-4.71);

    • history of dementia (1.39; 1.26-1.53);

    • smoking (1.45; 1.35-1.56);

    • stroke (1.07; 1.01-1.14);

    • depression (1.67; 1.57-1.76); and

    • injuries (1.54; 1.43-1.67).

  • Seizure freedom in the previous 12 months was associated with a lower risk of mortality (OR, 0.52; 95% CI, 0.41-0.65).

Limitations

  • Retrospective design.

  Wojewodka G, Gulliford MC, Ashworth M, Richardson MP, Ridsdale L. Epilepsy and mortality: a retrospective cohort analysis with a nested case-control study identifying causes and risk factors from primary care and linkage-derived data. BMJ Open. 2021;11(10):e052841. doi: 10.1136/bmjopen-2021-052841. PMID: 34697121  View full text

 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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