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Accidental deaths in young people with epilepsy and psychiatric comorbidity—A Danish nationwide cohort study
Author(s) -
Aagaard Sissel K.,
Dreier Julie W.,
Sun Yuelian,
Laursen Thomas M.,
Christensen Jakob
Publication year - 2020
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16453
Subject(s) - epilepsy , medicine , accidental , psychiatry , comorbidity , hazard ratio , danish , cohort , population , cohort study , pediatrics , confidence interval , environmental health , linguistics , philosophy , physics , acoustics
Objective The objective of this study was to investigate the accident‐related mortality among people younger than 55 years of age with epilepsy compared with the general population and to study how psychiatric comorbidity influences this risk. Methods This is a population‐based cohort study of individuals born in Denmark between 1960 and 2015 (n = 3, 665 616). Persons diagnosed with epilepsy and psychiatric disorders were identified in the Danish National Patient Register and the Danish Central Psychiatric Central Register. We estimated the hazard ratio (HR) with 95% confidence intervals (CIs) of accidental death in people with epilepsy compared with persons without epilepsy. Results We identified 61 330 persons (1.7%) diagnosed with epilepsy. Median age at end of follow‐up was 27.8 years. In people with epilepsy, 5253 died during follow‐up, 480 (9%) of whom died from accidents. Among people without epilepsy, 52 588 died during follow‐up, of whom 1280 (2.4%) died from accidents. People with epilepsy had a 3.7‐fold (95% CI 3.4‐4.1) increased risk of accidental death compared with persons without epilepsy. When we adjusted for psychiatric disorders, the risk remained significantly elevated in people with epilepsy compared to people without epilepsy (adjusted HR [aHR] 2.44, 95% CI 2.22‐2.69). When stratifying the analyses on epilepsy and psychiatric disorders, people with epilepsy and psychiatric disorders had an aHR of 4.95 (95% CI 3.82‐6.41) when compared with persons without epilepsy and psychiatric disorders. Significance The risk of accidental death was increased in people with epilepsy and was particularly high among people with epilepsy with psychiatric comorbidity. The findings highlight the need for awareness and prevention strategies in people with epilepsy, especially in people with comorbid psychiatric disorders.