Evolution over time of SUDEP incidence: A nationwide population‐based cohort study
Summary Prompted by a recent report on declining incidence of sudden unexpected death in epilepsy (SUDEP) following implantation of a vagus nerve stimulator (VNS), we analyzed SUDEP risk over 6 years in a population‐based cohort of 60 952 epilepsy patients in Sweden. All deaths from July 1, 2006 thr...
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| Veröffentlicht in: | Epilepsia (Copenhagen) 2018-08, Vol.59 (8), p.e120-e124 |
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| creator | Tomson, Torbjörn Sveinsson, Olafur Carlsson, Sofia Andersson, Tomas |
| description | Summary
Prompted by a recent report on declining incidence of sudden unexpected death in epilepsy (SUDEP) following implantation of a vagus nerve stimulator (VNS), we analyzed SUDEP risk over 6 years in a population‐based cohort of 60 952 epilepsy patients in Sweden. All deaths from July 1, 2006 through December 31, 2011, were identified. Those with epilepsy mentioned on the death certificate were adjudicated for SUDEP using medical records and autopsy reports. In all, 292 SUDEP cases were identified. Comparing the first years (2006‐2007) with the subsequent 4 years (2008‐2011), the crude and standardized (to the US 2000 population) incidence of SUDEP (whether or not possible SUDEP was included) was significantly lower during the second time period; Incidence rate ratios based on standardized rates was estimated at 0.76 (95% confidence interval [CI] 0.60‐0.97, P = .027) for SUDEP. The incidence of SUDEP decreased by 7% per year during the 6‐year follow‐up. Our data thus suggest that, for unknown reasons, incidence of SUDEP decreases with duration of follow‐up. This has implications for patient counseling as well as for the design of studies attempting to assess the effectiveness of an intervention against SUDEP, which clearly needs to include a control group. |
| doi_str_mv | 10.1111/epi.14460 |
| format | Article |
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Prompted by a recent report on declining incidence of sudden unexpected death in epilepsy (SUDEP) following implantation of a vagus nerve stimulator (VNS), we analyzed SUDEP risk over 6 years in a population‐based cohort of 60 952 epilepsy patients in Sweden. All deaths from July 1, 2006 through December 31, 2011, were identified. Those with epilepsy mentioned on the death certificate were adjudicated for SUDEP using medical records and autopsy reports. In all, 292 SUDEP cases were identified. Comparing the first years (2006‐2007) with the subsequent 4 years (2008‐2011), the crude and standardized (to the US 2000 population) incidence of SUDEP (whether or not possible SUDEP was included) was significantly lower during the second time period; Incidence rate ratios based on standardized rates was estimated at 0.76 (95% confidence interval [CI] 0.60‐0.97, P = .027) for SUDEP. The incidence of SUDEP decreased by 7% per year during the 6‐year follow‐up. Our data thus suggest that, for unknown reasons, incidence of SUDEP decreases with duration of follow‐up. This has implications for patient counseling as well as for the design of studies attempting to assess the effectiveness of an intervention against SUDEP, which clearly needs to include a control group.</description><identifier>ISSN: 0013-9580</identifier><identifier>EISSN: 1528-1167</identifier><identifier>DOI: 10.1111/epi.14460</identifier><identifier>PMID: 29905938</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Aged, 80 and over ; Autopsy ; Cohort analysis ; Cohort Studies ; Community Health Planning ; Death, Sudden - epidemiology ; Death, Sudden - etiology ; Epilepsy ; Epilepsy - epidemiology ; Epilepsy - therapy ; Female ; Humans ; Incidence ; Male ; Medical records ; Middle Aged ; mortality ; Population studies ; Population-based studies ; Risk Factors ; sudden unexpected death ; Sweden - epidemiology ; Vagus nerve ; Vagus Nerve Stimulation - methods</subject><ispartof>Epilepsia (Copenhagen), 2018-08, Vol.59 (8), p.e120-e124</ispartof><rights>Wiley Periodicals, Inc. © 2018 International League Against Epilepsy</rights><rights>Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.</rights><rights>Copyright © 2018 International League Against Epilepsy</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4260-f0184fd33b9875929b45b3d15926828623754c75093dc8dda20aabae8469142f3</citedby><cites>FETCH-LOGICAL-c4260-f0184fd33b9875929b45b3d15926828623754c75093dc8dda20aabae8469142f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fepi.14460$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fepi.14460$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29905938$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:139217420$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Tomson, Torbjörn</creatorcontrib><creatorcontrib>Sveinsson, Olafur</creatorcontrib><creatorcontrib>Carlsson, Sofia</creatorcontrib><creatorcontrib>Andersson, Tomas</creatorcontrib><title>Evolution over time of SUDEP incidence: A nationwide population‐based cohort study</title><title>Epilepsia (Copenhagen)</title><addtitle>Epilepsia</addtitle><description>Summary
Prompted by a recent report on declining incidence of sudden unexpected death in epilepsy (SUDEP) following implantation of a vagus nerve stimulator (VNS), we analyzed SUDEP risk over 6 years in a population‐based cohort of 60 952 epilepsy patients in Sweden. All deaths from July 1, 2006 through December 31, 2011, were identified. Those with epilepsy mentioned on the death certificate were adjudicated for SUDEP using medical records and autopsy reports. In all, 292 SUDEP cases were identified. Comparing the first years (2006‐2007) with the subsequent 4 years (2008‐2011), the crude and standardized (to the US 2000 population) incidence of SUDEP (whether or not possible SUDEP was included) was significantly lower during the second time period; Incidence rate ratios based on standardized rates was estimated at 0.76 (95% confidence interval [CI] 0.60‐0.97, P = .027) for SUDEP. The incidence of SUDEP decreased by 7% per year during the 6‐year follow‐up. Our data thus suggest that, for unknown reasons, incidence of SUDEP decreases with duration of follow‐up. This has implications for patient counseling as well as for the design of studies attempting to assess the effectiveness of an intervention against SUDEP, which clearly needs to include a control group.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Autopsy</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Community Health Planning</subject><subject>Death, Sudden - epidemiology</subject><subject>Death, Sudden - etiology</subject><subject>Epilepsy</subject><subject>Epilepsy - epidemiology</subject><subject>Epilepsy - therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>mortality</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Risk Factors</subject><subject>sudden unexpected death</subject><subject>Sweden - epidemiology</subject><subject>Vagus nerve</subject><subject>Vagus Nerve Stimulation - methods</subject><issn>0013-9580</issn><issn>1528-1167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10ctO3DAUBmALFcFAu-gLIEvdwCLge2x2aDpcJKQilVlbTuyohkwc4mRGs-sj8Iw8CYYMs0DCGx8ffTo61g_AT4xOcTpnrvWnmDGBdsAEcyIzjEX-DUwQwjRTXKJ9cBDjA0IoFzndA_tEKcQVlRNwP1uGeuh9aGBYug72fuFgqODf-e_ZHfRN6a1rSncOL2Bj3tgqNWAb2qF-f778fy5MdBaW4V_oehj7wa6_g93K1NH92NyHYH45u59eZ7d_rm6mF7dZyYhAWYWwZJWltFAy54qogvGCWpxKIYkUhOaclTlHitpSWmsIMqYwTjKhMCMVPQTZODeuXDsUuu38wnRrHYzXm9ZjqpxmMhecJH88-rYLT4OLvV74WLq6No0LQ9QEcUGlUjxP9Ncn-hCGrkm_SUpSrmTaPamTUZVdiLFz1XYFjPRbNDpFo9-jSfZoM3EoFs5u5UcWCZyNYOVrt_56kp7d3YwjXwFCypdx</recordid><startdate>201808</startdate><enddate>201808</enddate><creator>Tomson, Torbjörn</creator><creator>Sveinsson, Olafur</creator><creator>Carlsson, Sofia</creator><creator>Andersson, Tomas</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope></search><sort><creationdate>201808</creationdate><title>Evolution over time of SUDEP incidence: A nationwide population‐based cohort study</title><author>Tomson, Torbjörn ; Sveinsson, Olafur ; Carlsson, Sofia ; Andersson, Tomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4260-f0184fd33b9875929b45b3d15926828623754c75093dc8dda20aabae8469142f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Autopsy</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Community Health Planning</topic><topic>Death, Sudden - epidemiology</topic><topic>Death, Sudden - etiology</topic><topic>Epilepsy</topic><topic>Epilepsy - epidemiology</topic><topic>Epilepsy - therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>mortality</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Risk Factors</topic><topic>sudden unexpected death</topic><topic>Sweden - epidemiology</topic><topic>Vagus nerve</topic><topic>Vagus Nerve Stimulation - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tomson, Torbjörn</creatorcontrib><creatorcontrib>Sveinsson, Olafur</creatorcontrib><creatorcontrib>Carlsson, Sofia</creatorcontrib><creatorcontrib>Andersson, Tomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>Epilepsia (Copenhagen)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tomson, Torbjörn</au><au>Sveinsson, Olafur</au><au>Carlsson, Sofia</au><au>Andersson, Tomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evolution over time of SUDEP incidence: A nationwide population‐based cohort study</atitle><jtitle>Epilepsia (Copenhagen)</jtitle><addtitle>Epilepsia</addtitle><date>2018-08</date><risdate>2018</risdate><volume>59</volume><issue>8</issue><spage>e120</spage><epage>e124</epage><pages>e120-e124</pages><issn>0013-9580</issn><eissn>1528-1167</eissn><abstract>Summary
Prompted by a recent report on declining incidence of sudden unexpected death in epilepsy (SUDEP) following implantation of a vagus nerve stimulator (VNS), we analyzed SUDEP risk over 6 years in a population‐based cohort of 60 952 epilepsy patients in Sweden. All deaths from July 1, 2006 through December 31, 2011, were identified. Those with epilepsy mentioned on the death certificate were adjudicated for SUDEP using medical records and autopsy reports. In all, 292 SUDEP cases were identified. Comparing the first years (2006‐2007) with the subsequent 4 years (2008‐2011), the crude and standardized (to the US 2000 population) incidence of SUDEP (whether or not possible SUDEP was included) was significantly lower during the second time period; Incidence rate ratios based on standardized rates was estimated at 0.76 (95% confidence interval [CI] 0.60‐0.97, P = .027) for SUDEP. The incidence of SUDEP decreased by 7% per year during the 6‐year follow‐up. Our data thus suggest that, for unknown reasons, incidence of SUDEP decreases with duration of follow‐up. This has implications for patient counseling as well as for the design of studies attempting to assess the effectiveness of an intervention against SUDEP, which clearly needs to include a control group.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29905938</pmid><doi>10.1111/epi.14460</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Autopsy Cohort analysis Cohort Studies Community Health Planning Death, Sudden - epidemiology Death, Sudden - etiology Epilepsy Epilepsy - epidemiology Epilepsy - therapy Female Humans Incidence Male Medical records Middle Aged mortality Population studies Population-based studies Risk Factors sudden unexpected death Sweden - epidemiology Vagus nerve Vagus Nerve Stimulation - methods |
| title | Evolution over time of SUDEP incidence: A nationwide population‐based cohort study |
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