Temporal trends in the mortality of people with epilepsy: A review
Article first published online: 24 SEP 2010
Wiley Periodicals, Inc. © 2010 International League Against Epilepsy
Volume 51, Issue 11, pages 2241–2246, November 2010
How to Cite
Neligan, A., Bell, G. S., Shorvon, S. D. and Sander, J. W. (2010), Temporal trends in the mortality of people with epilepsy: A review. Epilepsia, 51: 2241–2246. doi: 10.1111/j.1528-1167.2010.02711.x
- Issue published online: 26 OCT 2010
- Article first published online: 24 SEP 2010
- Accepted July 12, 2010; Early View publication September 24, 2010.
- Temporal trends;
- Population studies
Purpose: It is now generally accepted that people with epilepsy are at increased risk of premature death compared with peers in the general population. It has, however, not been clearly established how this risk changes over time, nor whether mortality rates have been changing over time.
Methods: We carried out a systematic review: (1) To determine the pattern of change of mortality risk relative to the general population in people with epilepsy in the course of their condition as measured by standardized mortality ratios (SMRs), by reviewing longitudinal prospective cohort studies. (2) To establish whether there have been any changes in reported mortality rates for epilepsy in general populations over time. This was complemented by comparison of SMRs in people with epilepsy in the same types of source populations (population-based, hospital-based, and institutional studies) in different time periods to ascertain any changes in reported mortality rates.
Results: The SMR is highest in the initial years after diagnosis and subsequently decreases. There is a suggestion that there may be an increase after 10 years from diagnosis despite the fact that the majority of people in these cohorts are in long-term remission. There is no evidence that either the overall SMR or the mortality rate of people with epilepsy has changed significantly over time.
Discussion: Further population and cohort studies are needed to confirm these findings.