COMMUNITY-BASED STUDY OF MORTALITY IN CHILDREN WITH EPILEPSY

被引:106
作者
HARVEY, AS [1 ]
NOLAN, T [1 ]
CARLIN, JB [1 ]
机构
[1] UNIV MELBOURNE,ROYAL CHILDRENS HOSP RES FDN,DEPT PAEDIAT,PARKVILLE,VIC 3052,AUSTRALIA
关键词
EPILEPSY; MORTALITY; SEIZURES; CHILD; AUSTRALIA;
D O I
10.1111/j.1528-1157.1993.tb00434.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We used the records of a statewide pediatric mortality surveillance system to determine mortality rates and causes of death in children with epilepsy. Of the 1,095 children aged 1-14 years who died in the state of Victoria during the study period 1985-1989, 93 had a history of epilepsy. Six children (6%) had primary epilepsy, and 87 (94%) had secondary epilepsy. Death was (a) directly attributable to epilepsy in 20 (22%), including 11 with sudden unexplained death, (b) not directly attributable to epilepsy in 59 (63%), and (c) of undetermined cause in 14 (15%). No classifiable death occurred as a direct result of status epilepticus. The average annual mortality rates for children with epilepsy were (a) death from all causes, 30.6 in 10,000 [95% confidence interval (CI) 19.7, 47.5], and (b) death attributable to epilepsy, 6.6 in 10,000 (95% CI 3.7, 11.8). Relative to the all-cause mortality rate in children without epilepsy, the all-cause mortality rate ratios were (a) all children with epilepsy, 13.2 (95% CI 8.5, 20.7); (b) primary epilepsy, 1.1 (95% CI 0.5, 2.6); and (c) secondary epilepsy, 49.7 (95% CI 31.7, 77.9). The mortality rate ratios for secondary epilepsy relative to primary epilepsy were (a) death from all causes, 43.5 (95% CI 19.0, 99.5); and (b) death attributable to epilepsy, 9.0 (95% CI 3.3, 24.8). Epilepsy appeared on the death certificate of only 11 of 20 (55%) children whose deaths were attributable to epilepsy. We conclude that (a) there was an increased risk of death during childhood in children with epilepsy; (b) the risk of death was greatest for children with secondary epilepsy; (c) potentially preventable, epilepsy-related deaths occurred in children with primary epilepsy; (d) sudden unexplained death accounted for at least 12% of deaths; and (e) death certification was deficient with respect to recording of epilepsy.
引用
收藏
页码:597 / 603
页数:7
相关论文
共 31 条
[21]   PREDICTORS OF EPILEPSY IN CHILDREN WHO HAVE EXPERIENCED FEBRILE SEIZURES [J].
NELSON, KB ;
ELLENBERG, JH .
NEW ENGLAND JOURNAL OF MEDICINE, 1976, 295 (19) :1029-1033
[22]   SUDDEN AND UNEXPECTED NATURAL DEATH IN CHILDHOOD AND ADOLESCENCE [J].
NEUSPIEL, DR ;
KULLER, LH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1985, 254 (10) :1321-1325
[23]   ETIOLOGY AND MORTALITY OF STATUS EPILEPTICUS IN CHILDREN - A RECENT UPDATE [J].
PHILLIPS, SA ;
SHANAHAN, RJ .
ARCHIVES OF NEUROLOGY, 1989, 46 (01) :74-76
[24]   EPILEPSY IN CHILDHOOD - FINDINGS FROM THE NATIONAL CHILD-DEVELOPMENT STUDY [J].
ROSS, EM ;
PECKHAM, CS ;
WEST, PB ;
BUTLER, NR .
BRITISH MEDICAL JOURNAL, 1980, 280 (6209) :207-210
[25]  
ROTHMAN KJ, 1986, MODERN EPIDEMIOLOGY, P170
[26]  
RUTTER M, 1970, DEV MED CHILD NEUR S, P124
[27]   INCIDENCE AND PREVALENCE STUDIES IN EPILEPSY AND THEIR METHODOLOGICAL PROBLEMS - A REVIEW [J].
SANDER, JWAS ;
SHORVON, SD .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1987, 50 (07) :829-839
[28]  
Sillanpaa M., 1973, ACTA PAEDIATR SC S, V237, P1
[29]  
SILLANPAA M, 1990, ACTA PAEDIATR SCAND, V368, P30
[30]   EPILEPSY AND MORTALITY-RATE AND CAUSE OF DEATH [J].
ZIELINSKI, JJ .
EPILEPSIA, 1974, 15 (02) :191-201