A meta analysis of key risk factors for sudden unexpected death in epilepsy

Purpose: To examine the risk factors (RFs), associated with Sudden Unexpected Death in Epilepsy (SUDEP), and the quantitative standards required to measure them Methods: The literature on RFs associated with SUDEP was systematically reviewed up to August 2020 in databases, including PubMed, the Cochrane Database and Embase. Revised Newcastle-Ottawa Scale (NOS) was performed to determine the quality of each study in this meta-analysis (MA), with a score of ≥ 3, indicating good quality. Any controversies in data extraction and quality assessment were resolved through counsel or adjudication with a third researcher. Results: An initial screening of the literature following the search strategy and manual inclusion yielded a total of 767 studies. After excluding duplicates as well as articles that did not match the topic, 112 studies remained. Twenty-nine studies were finally selected based on the inclusion and exclusion criteria. After a careful review of the full text, nine studies were included in the MA. Conclusion: The five RFs for SUDEP included age at the onset of epilepsy ≤15 years, generalized-tonic-clonic seizure, seizure frequency ≥50 seizures/year, treatment with a combination of multiple antiepileptic drugs, and history of alcohol abuse.