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Overall and cause-specific premature mortality in epilepsy: A systematic review

Watila, MM; Balarabe, SA; Ojo, O; Keezer, MR; Sander, JW; (2018) Overall and cause-specific premature mortality in epilepsy: A systematic review. Epilepsy & Behavior , 87 pp. 213-225. 10.1016/j.yebeh.2018.07.017. Green open access

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Abstract

BACKGROUND: We conducted a systematic review to ascertain the overall mortality and causes of premature mortality in epilepsy. METHODOLOGY: We searched PubMed and Embase to identify relevant articles reporting mortality in epilepsy. An assessment of the methodological quality and overall quality of evidence of the identified studies was done using appropriate checklists. We extracted data from these studies reporting measures of overall and cause-specific mortality in epilepsy. RESULTS: Sixty-three articles from fifty-six cohorts met the eligibility criteria, thirty-three population- or community-based and twenty-three hospital- or institutional-based studies. The majority of studies are from high-income countries (HIC). These studies reported overall excess mortality for people with epilepsy, with wide variability reported for population- or community-based studies and from low- and middle-income countries (LMIC). Twenty-seven articles from twenty-three cohorts reported measures of mortality for cause-specific mortality in epilepsy. People with epilepsy from HIC and LMIC have a higher risk of dying from various causes compared with the general population. Those in LMIC, however, have a particularly high chance of dying from external causes such as drowning and suicide. We observed a decrement over time in measures of overall and cause-specific mortality in cohorts. CONCLUSIONS: Despite the heterogeneity in reports, our findings support the suggestions that people with epilepsy have an increased risk of premature mortality from various causes. Further work is needed to elucidate the mechanisms, to determine biomarkers for predicting those at risk, and to understand the implications of counseling and preventive strategies.

Type: Article
Title: Overall and cause-specific premature mortality in epilepsy: A systematic review
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.yebeh.2018.07.017
Publisher version: http://doi.org/10.1016/j.yebeh.2018.07.017
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Causes, Epilepsy death, External causes, Neoplasms, Seizures
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/10057049
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