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Study reveals higher risk of early death varies based on different factors in epilepsy

by Pragati Singh

According to a new study, those who suffer from epilepsy are more likely to die early. The elevated risk varies according to the individual’s location, the number of drugs they take, and any other ailments they may have. The findings were published online in Neurology, the official journal of the American Academy of Neurology.

“Our research found an increased risk even among those who do not have other health problems and are taking only one medication to control their seizures,” said study author Seo-Young Lee, MD, Ph.D., of Kangwon National University in Chuncheon, Republic of Korea.

The researchers identified 138,998 persons newly treated for epilepsy using a national health database. The researchers next analysed the national death record and discovered that 20,095 study participants died throughout the 10-year study period. At the commencement of the trial, the average age of the participants was 49.

Researchers recorded the reasons for death for all subjects. They also recorded information such as a person’s age, gender, where they resided, and the number of prescriptions they had been prescribed. The researchers then computed the total fatality rates for study participants. The mortality rate is a measure of the total number of deaths in a given population. The mortality rates of study participants were compared to the general population’s death rates.

There were roughly 660,000 person-years among research participants, which indicate both the number of persons in the study and the amount of time each person spends in the study. There were 20,095 fatalities in research participants for that number of person-years, compared to an estimated 8,929 deaths in the general population.

Using person-years to quantify risk, researchers discovered that patients with epilepsy had a risk of mortality that was more than double that of the general population. The elevated risk was significantly greater in the study’s younger participants. Furthermore, those with epilepsy residing in rural locations had a 247 percent higher risk of mortality than the general population, while those living in urban areas had a 203% higher risk.

Participants in the study who used just one anti-seizure medicine had a 156% increased risk of mortality compared to the general population, while those who took four or more anti-seizure medications had a nearly fivefold increased risk.

When compared to the general population, people with epilepsy who had no other illnesses or health issues had a 161% greater chance of mortality. Those with epilepsy who had never or only once been hospitalised showed no higher risk of dying prematurely.

Among study participants who died, 19% died of cerebrovascular disease, which had a 4.5 times higher risk of death than the general population, 16% died of cancers outside the central nervous system, which had a 137% higher risk, and 7% died of cancers in the central nervous system, which had a 46 times higher risk.

According to Lee, such malignancies and cerebrovascular disease are commonly thought to be underlying causes of epilepsy. In addition, 6 percent died of pneumonia, 7 percent died of external causes such as falls, accidents, and drowning and 2 percent died of suicide, all of which had a two times greater risk. Epilepsy and status epilepticus were responsible for 2% of all fatalities.

“Our study demonstrated a wide range of mortality risks in people with epilepsy, depending on age, disease duration, disease severity, and other health conditions,” said Lee. “We also identified disparities for people living in rural areas and urge public health efforts to improve access to care. Active control of seizures, education about injury prevention, monitoring for suicidal thoughts, and efforts to improve accessibility to epilepsy care all contribute to reducing mortality.”

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