title: Injury among children and young adults with epilepsy.
abstract: OBJECTIVE
  To investigate whether children and young adults with epilepsy are at a greater risk of fracture, thermal injury, or poisoning than those without.
  
  
  METHODS
  A cohort study was conducted by using the Clinical Practice Research Datalink (1987-2009), a longitudinal database containing primary care records. A total of 11 934 people with epilepsy and 46 598 without, aged between 1 and 24 years at diagnosis, were followed for a median (interquartile range) of 2.6 (0.8-5.9) years. The risk of fractures (including long bone fractures), thermal injuries, and poisonings (including medicinal and nonmedicinal poisonings) was estimated.
  
  
  RESULTS
  Adjusting for age, gender, Strategic Health Authority region, deprivation, and calendar year at study entry (and, for medicinal poisonings, behavior disorder), people with epilepsy had an 18% increase in risk of fracture (hazard ratio [HR] = 1.18; 95% confidence interval [CI], 1.09-1.27), a 23% increase in risk of long bone fracture (HR = 1.23; 95% CI, 1.10-1.38), a 49% increase in risk of thermal injury (HR = 1.49; 95% CI, 1.27-1.75), and more than twice the risk of poisoning (HR = 2.47; 95% CI, 2.15-2.84), which was limited to poisoning from medicinal products (medicinal HR = 2.54; 95% CI, 2.16-2.99; nonmedicinal HR = 0.96; 95% CI, 0.61-1.52).
  
  
  CONCLUSIONS
  Children and young adults with epilepsy are at a greater risk of fracture, thermal injury, and poisoning than those without. The greatest risk is from medicinal poisonings. Doctors and other health care professionals should provide injury and poison prevention advice at diagnosis and epilepsy reviews.
authors.affiliation: University of Nottingham, Nottingham, England; and vibhore.prasad@nottingham.ac.uk.
authors.forename: Vibhore
authors.initials: V
authors.lastname: Prasad
authors.affiliation: University of Nottingham, Nottingham, England; and.
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
authors.affiliation: University of Nottingham, Nottingham, England; and.
authors.forename: Kapil
authors.initials: K
authors.lastname: Sayal
authors.affiliation: London School of Hygiene and Tropical Medicine, London, England.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Thomas
authors.affiliation: University of Nottingham, Nottingham, England; and.
authors.forename: Joe
authors.initials: J
authors.lastname: West
mesh_terms: D000293:Adolescent; D002056:Burns / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004739:England; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011041:Poisoning / Q000175:diagnosis / Q000453:epidemiology; D055553:Prescription Drugs / Q000506:poisoning; D016016:Proportional Hazards Models; D012306:Risk; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D055553:Prescription Drugs
keywords: burns; epilepsy; fractures; injury; poisoning