Cause of mortality among people with epilepsy in Malaysia: A hospital-based study

Khor, Si-Bao and Lim, Kheng-Seang and Fong, Si-Lei and Ho, Jun-Hui and Koh, May-Yi and Tan, Chong-Tin (2022) Cause of mortality among people with epilepsy in Malaysia: A hospital-based study. Epilepsy Research, 181. ISSN 0920-1211, DOI

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Background: This is a follow-up study on mortality in adult patients in Malaysia. This study aimed to determine the cause of death and the factors associated with epilepsy-related death in PWE in Malaysia. Method: Deceased PWE from 2005 to 2020 were identified from the National Registry Department of Malaysia. The details of the cause of death and predictors for epilepsy-related deaths was ascertained from medical records and phone interviews. Result: There were a total of 227 deaths, 144 (63.4%) were male, two (0.9%) underwent autopsy and 46.3% passed away in the community. The majority of deaths (55.5%) were due to causes unrelated to epilepsy. Fortyfive (19.8%) death were related to epilepsy, of which, 22 (9.7%) were due to death directly related to epilepsy including probable SUDEP (5.3%) and status epilepticus (4.4%). The cause of death was unknown in 56 (24.7%) cases. Binary logistic regression analysis identified 3 predictors for epilepsy-related deaths, i.e., structural causes (OR 3.09, 95% CI 1.100-8.691, p = 0.032), younger age of death (OR 2.35, 95% CI 1.039-5.333, p = 0.040) and history of brain surgery (OR 8.09, 95% CI 2.014-32.510, p = 0.003). Twelve (5.3%) had probable SUDEP. The incidence rate of probable SUDEP was 0.42 per 1000 person-years. The majority of them had intellectual disability (9/12), generalized tonic-clonic seizures (9/12), and 2 or more ASMs (9/12). Conclusion: Epilepsy-related deaths accounted for 20% of the deaths in PWE, associated with structural cause, younger age of death, and previous brain surgery. Probable SUDEP is not uncommon in Malaysia and could be under-diagnosed.

Item Type: Article
Funders: University of Malaya Specialist Center (UMSC) CA.R.E [Grant No: PV 056-2018], Impact Oriented Interdisciplinary Research Grant (IIRG) Program [Grant No: IIRG003A-2020HWB]
Uncontrolled Keywords: Mortality; Cause of death; Risk factors; Epilepsy; Malaysia
Subjects: R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 19 Sep 2023 04:56
Last Modified: 19 Sep 2023 04:56

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