中突然意外死亡的危险因素:一个病例控制研究
L Nilsson1, B Y Farahmand, P G Persson
1Department of Neurological Rehabilitation, Stora Sköndal Hospital, Sweden. lena.weine@swipnet.se
Lancet (London, England)
|March 27, 1999
概括
在中突然意外死亡 (SUDEP) 的风险随着发作频率和多疗法而增加. 早期发病和频繁的抗药剂量变化也是危险因素. 改善控制可能会减少SUDEP.
科学领域:
- 神经学 神经学
- 的研究研究.
- 公共卫生 公共卫生
背景情况:
- 中突然意外死亡 (SUDEP) 是一个重大问题,在患者中比一般人群更频繁地发生.
- 确定与SUDEP相关的临床变量对于风险分层和预防至关重要.
研究的目的:
- 调查临床变量与中突然意外死亡 (SUDEP) 之间的关联.
- 在患者中确定SUDEP的特定风险因素.
主要方法:
- 一项嵌套病例对照研究使用来自斯德哥尔摩的15-70岁患者队列 (1980-1989) 进行.
- 病例是因而死亡并符合SUDEP标准的个体,每个病例有三个年龄和性别匹配的活着患者对照.
- 分析了医疗记录和尸体解剖结果,以收集和评估临床数据.
主要成果:
- 较高的发作频率 (例如,每年超过50次) 显著增加了SUDEP风险 (RR 10.16).
- 与单独治疗相比,同时使用三种或更多的抗药物 (AED) 显著增加了SUDEP风险 (RR 9.89).
- 早期发作的 (RR 7.72) 和频繁的AED剂量变化 (RR 6.08) 被确定为主要的危险因素.
结论:
- 中突然意外死亡 (SUDEP) 似乎与有关,潜在的易感因素在生命早期就已确立.
- 在SUDEP风险关联中观察到性别差异,女性对剂量变化的联系更强.
- 改善控制和潜在地避免多疗法是减轻SUDEP风险的建议策略.
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