Increased mortality risk in epilepsy associated with male sex, older age at onset

Key takeaways:

• Researchers examined more than 2,400 individuals with epilepsy over 30 years.
• Additional analysis, including sudden unexpected death in epilepsy, have yet to be completed.

ORLANDO — For those with epileptic seizures, male sex and increased age at onset, as well as a history of partial seizures carried the greatest risk of mortality in a cohort of individuals after 30 years, according to a poster.

“Our research is looking at 30 years of data from an epileptology practice in South Carolina,” Angela M. Malek, PhD, associate professor in the department of public health sciences division of epidemiology at Medical University of South Carolina, told Healio during her presentation at the American Epilepsy Society annual meeting.

Malek and colleagues sought to describe demographic and clinical characteristics of a large cohort of individuals across all age groups with epilepsy between 1974 and 2004.

Their retrospective cohort study drew mortality data from the National Death Index through 2016 to include 2,459 persons (51.7% male; 55.3% Black; 55.3% aged 18 and older) with a diagnosis of epilepsy, along with a subset for analysis of 1,205 individuals whose records showed antiepileptic medication use information.

Unadjusted and adjusted logistic regression models were employed to estimate odds ratios and 95% confidence intervals for associations between characteristics of the population and all-cause mortality.

According to results, 306 individuals in the cohort had died by 2016.

Researchers found the odds of all-cause mortality were higher for men in all age categories (age 19 to 39 years, OR = 1.71 [1.28-2.29]; age 40 to 64 years, OR = 3.73 [2.65-5.25]; age 65 years and older, OR = 4.61 [2.96-7.18]) compared with women (OR = 1.69 [1.26-2.27]; OR 3.68 [2.59-5.22]; OR = 4.3 [2.73-6.78]).

The most prevalent medications for those with complete records were Dilantin, Phenobarbital, Neurontin and Depakote.

Data further showed that having partial seizures carried significant association with mortality after adjusting for age at onset, sex and race.

“We found that mortality was increased for males and increased for those 65 and older, but we did not see differences by race at this time,” Malek told Healio.