title: The burden of premature mortality of epilepsy in high-income countries: A systematic review from the Mortality Task Force of the International League Against Epilepsy.
abstract: Since previous reviews of epidemiologic studies of premature mortality among people with epilepsy were completed several years ago, a large body of new evidence about this subject has been published. We aim to update prior reviews of mortality in epilepsy and to reevaluate and quantify the risks, potential risk factors, and causes of these deaths. We systematically searched the Medline and Embase databases to identify published reports describing mortality risks in cohorts and populations of people with epilepsy. We reviewed relevant reports and applied criteria to identify those studies likely to accurately quantify these risks in representative populations. From these we extracted and summarized the reported data. All population-based studies reported an increased risk of premature mortality among people with epilepsy compared to general populations. Standard mortality ratios are especially high among people with epilepsy aged <50 years, among those whose epilepsy is categorized as structural/metabolic, those whose seizures do not fully remit under treatment, and those with convulsive seizures. Among deaths directly attributable to epilepsy or seizures, important immediate causes include sudden unexpected death in epilepsy (SUDEP), status epilepticus, unintentional injuries, and suicide. Epilepsy-associated premature mortality imposes a significant public health burden, and many of the specific causes of death are potentially preventable. These require increased attention from healthcare providers, researchers, and public health professionals.
authors.affiliation: Department of Neurology, School of Medicine, Emory University, Atlanta, Georgia, U.S.A.
authors.forename: David J
authors.initials: DJ
authors.lastname: Thurman
authors.affiliation: Department of Clinical Research in Neurology, University of Bari "Aldo Moro,", Pia Fondazione Cardinale G. Panico, Lecce, Italy.|Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro,", Bari, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Logroscino
authors.affiliation: Mario Negri Institute, Milan, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
authors.affiliation: Sergievsky Center and Mailman School of Public Health, Columbia University, New York City, New York, U.S.A.
authors.forename: W Allen
authors.initials: WA
authors.lastname: Hauser
authors.affiliation: Sergievsky Center and Mailman School of Public Health, Columbia University, New York City, New York, U.S.A.
authors.forename: Dale C
authors.initials: DC
authors.lastname: Hesdorffer
authors.affiliation: Department of Neurosciences, Institute of Child Health, University College London, London, United Kingdom.|Department of Paediatrics, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.|Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Newton
authors.affiliation: Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Fulvio Alexandre
authors.initials: FA
authors.lastname: Scorza
authors.affiliation: NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, United Kingdom.|Epilepsy Institute of The Netherlands Foundation (SEIN), Heemstede, The Netherlands.
authors.forename: Josemir W
authors.identifier: 0000-0001-6041-9661
authors.initials: JW
authors.lastname: Sander
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Tomson
mesh_terms: D000367:Age Factors; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D003645:Death, Sudden / Q000209:etiology*; D019049:Developed Countries; D004827:Epilepsy / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D061213:Mortality, Premature; D012307:Risk Factors; D012737:Sex Factors
keywords: Convulsions; Death; Developed countries; Premature mortality; Resource-rich countries; Seizures