Cause-Specific Mortality in Adults with Unprovoked Seizures
A Population-Based Incidence Cohort StudyRafnsson V. · Ólafsson E. · Hauser W.A. · Gudmundsson G.
aDepartment of Preventive Medicine, University of Iceland, and bDepartment of Neurology, National University Hospital, Reykjavik, Iceland; cDepartment of Neurology and School of Public Health, College of Physicians and Surgeons, Columbia University, New York, N.Y., USA
Purpose: To determine the cause-specific mortality relative to that expected in a population-based incidence cohort of people with unprovoked seizures. Methods: The cohort comprises 224 inhabitants of Iceland first diagnosed as suffering from unprovoked seizures during a 5-year period from 1960 to 1964. The expected number of deaths was calculated by multiplying person-years of observation within 5-year age categories for each year from diagnosis through 1995 by cause-specific and sex-specific national death rates for those aged 20 years and above. The standardized mortality ratio (SMR) and 95% confidence intervals (95% CI) were calculated. Results: All-cause mortality was increased among men (SMR 2.25, 95% CI 1.56–3.14) but not women (SMR 0.79, 95% CI 0.38–1.46). Among men, there were 8 deaths from accidents, poisoning and violence observed versus 2.82 expected (SMR 2.84, 95% CI 1.22–5.59) and 4 deaths from suicide versus 0.69 expected (SMR 5.80, 95% CI 1.56–14.84). All-cause mortality for men was still elevated after restriction of analysis to those with seizures of unknown etiology (SMR 1.73, 95% CI 1.05–2.67) with the excess deaths attributable to suicide (SMR 5.26, 95% CI 1.06–15.38). Both males and females with remote symptomatic unprovoked seizures had an increase in all-cause mortality due to excess mortality from all cancers, cerebrovascular disease and accidents. Conclusion: When compared with the age-, time-period- and gender-specific mortality in the general population, there is excess mortality in men but not women. The increased mortality for men is partly attributable to excess mortality from accidents and suicides.
Vilhjálmur Rafnsson, MD
Department of Preventive Medicine
IS–105 Reykjavik (Iceland)
Tel. +354 525 5213, Fax +354 562 2013, E-Mail firstname.lastname@example.org
Presented in part at the Annual Meeting of the American Epilepsy Society in San Diego, Calif., USA, December 6–9, 1998.
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 3, Number of References : 17
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Vol. 20, No. 4, Year 2001 (Cover Date: October 2001)
Journal Editor: G.C. Román, San Antonio, Tex.
ISSN: 0251–5350 (print), 1423–0208 (Online)
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