title: Complications of epilepsy surgery in Sweden 1996-2010: a prospective, population-based study.
abstract: OBJECTIVE
  Detailed risk information is essential for presurgical patient counseling and surgical quality assessments in epilepsy surgery. This study was conducted to investigate major and minor complications related to epilepsy surgery in a large, prospective series.
  
  
  METHODS
  The Swedish National Epilepsy Surgery Register provides extensive population-based data on all patients who were surgically treated in Sweden since 1990. The authors have analyzed complication data for therapeutic epilepsy surgery procedures performed between 1996 and 2010. Complications are classified as major (affecting daily life and lasting longer than 3 months) or minor (resolving within 3 months).
  
  
  RESULTS
  A total of 865 therapeutic epilepsy surgery procedures were performed between 1996 and 2010, of which 158 were reoperations. There were no postoperative deaths. Major complications occurred in 26 procedures (3%), and minor complications in 65 (7.5%). In temporal lobe resections (n = 523), there were 15 major (2.9%) and 41 minor complications (7.8%); in extratemporal resections (n = 275) there were 9 major (3.3%) and 22 minor complications (8%); and in nonresective procedures (n = 67) there were 2 major (3%) and 2 minor complications (3%). The risk for any complication increased significantly with age (OR 1.26 per 10-year interval, 95% CI 1.09-1.45). Compared with previously published results from the same register, there is a trend toward lower complication rates, especially in patients older than 50 years.
  
  
  CONCLUSIONS
  This is the largest reported prospective series of complication data in epilepsy surgery. The complication rates comply well with published results from larger single centers, confirming that epilepsy surgery performed in the 6 Swedish centers is safe. Patient age should be taken into account when counseling patients before surgery.
authors.affiliation: Epilepsy Research Group, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and.
authors.forename: Johan
authors.initials: J
authors.lastname: Bjellvi
authors.forename: Roland
authors.initials: R
authors.lastname: Flink
authors.forename: Bertil
authors.initials: B
authors.lastname: Rydenhag
authors.forename: Kristina
authors.initials: K
authors.lastname: Malmgren
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012086:Reoperation / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: AH = amygdalohippocampectomy; SNESUR = Swedish National Epilepsy Surgery Register; TLR = temporal lobe resection; adverse effects; epilepsy; epilepsy surgery; multicenter study; neurosurgery