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Abstract
Objective To study the risk for injuries/accidents in people with newly diagnosed epileptic seizures in relation to comorbidities.
Methods Between September 1, 2001, and August 31, 2008, individuals in northern Stockholm with incident unprovoked seizures (epilepsy; n = 2,130) were included in a registry. For every epilepsy patient, 8 individuals matched for sex and inclusion year (n = 16,992) were randomly selected as references from the population of the catchment area. Occurrence of injuries/accidents was monitored through the national patient and cause of death registers until December 31, 2013. These registers also provided information on comorbidities (e.g., brain tumor, stroke, psychiatric disease, diabetes mellitus).
Results Injury/accident was demonstrated in 1,033 epilepsy cases and 6,202 references (hazard ratio [HR] 1.71, 95% confidence interval 1.60–1.83). The excess risk was seen mainly during the first 2 years after diagnosis. Sex and educational status had no significant effect on HR. The risk was normal in children but increased in adults. Highest HR was seen for drowning, poisoning, adverse effect of medication, and severe traumatic brain injury. Compared to references without comorbidities, HR was 1.17 (1.07–1.28) in epilepsy without comorbidities, 4.52 (4.18–4.88) in references with comorbidities, and 7.15 (6.49–7.87) in epilepsy with comorbidities.
Conclusion Presence of comorbidities should be considered when counseling patients with newly diagnosed epilepsy concerning risk for injuries/accidents. Early information is important, as the risk is highest during the first 2 years following seizure onset.
Glossary
- CI=
- confidence interval;
- HR=
- hazard ratio;
- ICD-10=
- International Classification of Diseases–10;
- RERI=
- relative excess risk due to interaction;
- SIRE=
- Stockholm Incidence Registry of Epilepsy;
- TBI=
- traumatic brain injury
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
CME Course: NPub.org/cmelist
Patient Page: NPub.org/patient
- Received August 28, 2017.
- Accepted in final form November 28, 2017.
- © 2018 American Academy of Neurology
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