Mortality following status epilepticus in persons with and without epilepsy
Autor: | Gabriel U. Martz, Dulaney A. Wilson, Anbesaw W. Selassie, Gigi Smith, Angela M. Malek, Janelle L. Wagner, Braxton B. Wannamaker, Jonathan C. Edwards |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population Kaplan-Meier Estimate Status epilepticus Young Adult 03 medical and health sciences Epilepsy Status Epilepticus 0302 clinical medicine Risk Factors Internal medicine Epidemiology medicine Risk of mortality Humans 030212 general & internal medicine Child education Aged Proportional Hazards Models education.field_of_study business.industry Incidence (epidemiology) Hazard ratio Age Factors Infant General Medicine Middle Aged medicine.disease Surgery Neurology Child Preschool Cohort Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies |
Zdroj: | Seizure. 42:7-13 |
ISSN: | 1059-1311 |
Popis: | Purpose Incidence of status epilepticus (SE) ranges from 6.8 to 41.0 per 100,000 population. Although SE is associated with significant morbidity and mortality, the temporal relationship between SE, epilepsy, and mortality is less clear. The risk of all-cause mortality following SE with and without prior epilepsy was investigated. Method This study identified hospitalizations and emergency department visits for persons with SE and persons with epilepsy between 2000 and 2013. Excluded were those with epilepsy subsequent to SE, epilepsia partialis continua, less than 90days follow-up, and less than 2 years of data prior to first diagnosis. The cohort was grouped into: 1) SE only, 2) post-epilepsy SE (PES), and 3) epilepsy only. The risk of mortality was estimated using Cox proportional hazard models adjusting for potential confounders. Results The cohort (N=82,331) consisted of 1296 SE only cases (1.6%); 2136 PES cases (2.6%); and 78,899 epilepsy only controls (95.8%) with 24.9%, 29.2% and 20.0% mortality, respectively. Compared with controls, the hazard of mortality was increased for those with SE only (hazard ratio [HR]=1.61, 95% CI=1.41–1.82) and PES (HR=1.16, 95% CI=1.07–1.25) after adjustment for demographic and clinical factors. Prior stroke, central nervous system infection, and brain tumor increased the mortality hazard. Conclusion There is a statistically significant increased risk of all-cause mortality with SE. The risk is stronger in those with no prior epilepsy. Specific etiologies increase mortality risk in those with SE warranting further investigation of the complex associations between these etiologies and SE. |
Databáze: | OpenAIRE |
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