Document Detail


Premature mortality in refractory partial epilepsy: does surgical treatment make a difference?
MedLine Citation:
PMID:  20478848     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Epilepsy carries an increased risk of premature death. For some people with intractable focal epilepsy, surgery offers hope for a seizure-free life. The authors aimed to see whether epilepsy surgery influenced mortality in people with intractable epilepsy.
METHODS: The authors audited survival status in two cohorts (those who had surgery and those who had presurgical assessment but did not have surgery).
RESULTS: There were 40 known deaths in the non-surgical group (3365 person years of follow-up) and 19 in the surgical group (3905 person-years of follow-up). Non-operated patients were 2.4 times (95% CI 1.4 to 4.2) as likely to die as those who had surgery. They were 4.5 times (95% CI 1.9 to 10.9) as likely to die a probable epilepsy-related death. In the surgical group, those with ongoing seizures 1 year after surgery were 4.0 (95% CI 1.2 to 13.7) times as likely to die as those who were seizure-free or who had only simple partial seizures. Time-dependent Cox analysis showed that the yearly outcome group did not significantly affect mortality (HR 1.3, 95% CI 0.9 to 1.8).
CONCLUSION: Successful epilepsy surgery was associated with a reduced risk of premature mortality, compared with those with refractory focal epilepsy who did not have surgical treatment. To some extent, the reduced mortality is likely to be conferred by inducing freedom from seizures. It is not certain whether better survival is attributable only to surgery, as treatment decisions were not randomised, and there may be inherent differences between the groups.
Authors:
G S Bell; S Sinha; J de Tisi; C Stephani; C A Scott; W F Harkness; A W McEvoy; J L Peacock; M C Walker; S J Smith; J S Duncan; J W Sander
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-16
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  81     ISSN:  1468-330X     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-28     Completed Date:  2010-07-09     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  716-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cohort Studies
Epilepsies, Partial / mortality*,  surgery*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neurosurgical Procedures
Regression Analysis
Seizures / epidemiology
Survival Analysis
Treatment Outcome
Young Adult
Grant Support
ID/Acronym/Agency:
G9805989//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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