Epilepsy, antiepileptic drugs, and serious transport accidents: A nationwide cohort study
OBJECTIVESTo investigate the association between epilepsy and antiepileptic drugs and serious transport accidents requiring emergency care or resulting in death. METHODSWe identified 29,220 individuals 18 years or older with epilepsy without cerebral palsy or intellectual disability and 267,637 matc...
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| Veröffentlicht in: | Neurology 2018-03, Vol.90 (13), p.e1111-e1118 |
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| creator | Sundelin, Heléne E.K Chang, Zheng Larsson, Henrik Lichtenstein, Paul Almqvist, Catarina Tomson, Torbjörn Ludvigsson, Jonas F |
| description | OBJECTIVESTo investigate the association between epilepsy and antiepileptic drugs and serious transport accidents requiring emergency care or resulting in death.
METHODSWe identified 29,220 individuals 18 years or older with epilepsy without cerebral palsy or intellectual disability and 267,637 matched controls using Swedish registers. This nationwide cohort was followed from 2006 to 2013 for serious transport accidents. We used Cox regression to analyze the risk of serious transport accidents between individuals with epilepsy and matched controls, and then stratified Cox regression to compare the risk during periods of medication with the risk during nonmedication period within the same individual with epilepsy. We adjusted for civil status, employment, education, living area, psychiatric disorders prior to the start of follow-up, and psychotropic medication.
RESULTSCompared to matched controls, individuals with epilepsy were at increased risk of serious transport accidents (hazard ratio [HR] 1.37; 95% confidence interval [CI] 1.29–1.46). There were increased risks of pedestrian accidents (HR 2.24, 95% CI 1.69–2.97), bicycle accidents (HR 1.68, 95% CI 1.49–1.89) and car accidents (HR 1.31, 95% CI 1.19–1.44). However, among patients with a diagnosis of epilepsy, use of antiepileptic drugs did not influence the risk of serious transport accidents in population-level comparisons (HR 0.97; 95% CI 0.85–1.11) or within-individual comparisons (HR 0.99; 95% CI 0.69–1.42).
CONCLUSIONSerious transportation accidents were more common in individuals with epilepsy, but this risk was independent of use of antiepileptic drugs. |
| doi_str_mv | 10.1212/WNL.0000000000005210 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_490141</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2009570301</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4730-9ce13388273285e78079b450740ec784c5a3f7523a6b32f9145ec0fb497afce73</originalsourceid><addsrcrecordid>eNp9kltv0zAUxy0EYmXwDRDKIw_L8DV2eECqxgZIFbxwfbJc56Q1S-NgO1T99nNoqTYkZsmyfc7vXGz_EXpO8DmhhL769nFxjm8NQQl-gGZE0KqsGP3-EM0wpqpkSqoT9CTGnxhnp6wfoxNa8xrXhM7Qj8vBdTDE3Vlh-uTgzyk5WzRhXMXJ2BQRgvNjLFIwfRx8SIWx1jXQp_i6mBe9Sc7322worF9P7pjGZvcUPWpNF-HZYT1FX64uP1-8Lxef3n24mC9KyyXDZW2BMKYUlYwqAVJhWS-5wJJjsFJxKwxrpaDMVEtG25pwARa3S15L01qQ7BSV-7xxC8O41ENwGxN22hunD6brvAOdr0w4yfzZf_m37utc-7DKc9SV4orcm_6Id27URGCGeebf7PkMb6Cx-ZWC6e6E3fX0bq1X_rcWSuGKTfd5eUgQ_K8RYtIbFy10nekh_4KmGNdC5lpTb3yP2uBjDNAeyxCsJ5HoLBL9r0hy2IvbLR6D_qoiA2oPbH2XIMTrbtxC0GswXVrfn_sGwVzLBA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2009570301</pqid></control><display><type>article</type><title>Epilepsy, antiepileptic drugs, and serious transport accidents: A nationwide cohort study</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><source>SWEPUB Freely available online</source><source>Journals@Ovid Complete</source><creator>Sundelin, Heléne E.K ; Chang, Zheng ; Larsson, Henrik ; Lichtenstein, Paul ; Almqvist, Catarina ; Tomson, Torbjörn ; Ludvigsson, Jonas F</creator><creatorcontrib>Sundelin, Heléne E.K ; Chang, Zheng ; Larsson, Henrik ; Lichtenstein, Paul ; Almqvist, Catarina ; Tomson, Torbjörn ; Ludvigsson, Jonas F</creatorcontrib><description>OBJECTIVESTo investigate the association between epilepsy and antiepileptic drugs and serious transport accidents requiring emergency care or resulting in death.
METHODSWe identified 29,220 individuals 18 years or older with epilepsy without cerebral palsy or intellectual disability and 267,637 matched controls using Swedish registers. This nationwide cohort was followed from 2006 to 2013 for serious transport accidents. We used Cox regression to analyze the risk of serious transport accidents between individuals with epilepsy and matched controls, and then stratified Cox regression to compare the risk during periods of medication with the risk during nonmedication period within the same individual with epilepsy. We adjusted for civil status, employment, education, living area, psychiatric disorders prior to the start of follow-up, and psychotropic medication.
RESULTSCompared to matched controls, individuals with epilepsy were at increased risk of serious transport accidents (hazard ratio [HR] 1.37; 95% confidence interval [CI] 1.29–1.46). There were increased risks of pedestrian accidents (HR 2.24, 95% CI 1.69–2.97), bicycle accidents (HR 1.68, 95% CI 1.49–1.89) and car accidents (HR 1.31, 95% CI 1.19–1.44). However, among patients with a diagnosis of epilepsy, use of antiepileptic drugs did not influence the risk of serious transport accidents in population-level comparisons (HR 0.97; 95% CI 0.85–1.11) or within-individual comparisons (HR 0.99; 95% CI 0.69–1.42).
CONCLUSIONSerious transportation accidents were more common in individuals with epilepsy, but this risk was independent of use of antiepileptic drugs.</description><identifier>ISSN: 0028-3878</identifier><identifier>ISSN: 1526-632X</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000005210</identifier><identifier>PMID: 29490912</identifier><language>eng</language><publisher>United States: American Academy of Neurology</publisher><subject>Accidents, Traffic ; Adolescent ; Adult ; Anticonvulsants - therapeutic use ; Cohort Studies ; Emergency Medical Services ; Epilepsy - epidemiology ; Epilepsy - therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Mental Disorders - epidemiology ; Middle Aged ; Psychotropic Drugs - therapeutic use ; Risk ; Socioeconomic Factors ; Sweden ; Young Adult</subject><ispartof>Neurology, 2018-03, Vol.90 (13), p.e1111-e1118</ispartof><rights>2018 American Academy of Neurology</rights><rights>2018 American Academy of Neurology.</rights><rights>2018 American Academy of Neurology 2018 American Academy of Neurology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4730-9ce13388273285e78079b450740ec784c5a3f7523a6b32f9145ec0fb497afce73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,550,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29490912$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-150304$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-68481$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:138799601$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Sundelin, Heléne E.K</creatorcontrib><creatorcontrib>Chang, Zheng</creatorcontrib><creatorcontrib>Larsson, Henrik</creatorcontrib><creatorcontrib>Lichtenstein, Paul</creatorcontrib><creatorcontrib>Almqvist, Catarina</creatorcontrib><creatorcontrib>Tomson, Torbjörn</creatorcontrib><creatorcontrib>Ludvigsson, Jonas F</creatorcontrib><title>Epilepsy, antiepileptic drugs, and serious transport accidents: A nationwide cohort study</title><title>Neurology</title><addtitle>Neurology</addtitle><description>OBJECTIVESTo investigate the association between epilepsy and antiepileptic drugs and serious transport accidents requiring emergency care or resulting in death.
METHODSWe identified 29,220 individuals 18 years or older with epilepsy without cerebral palsy or intellectual disability and 267,637 matched controls using Swedish registers. This nationwide cohort was followed from 2006 to 2013 for serious transport accidents. We used Cox regression to analyze the risk of serious transport accidents between individuals with epilepsy and matched controls, and then stratified Cox regression to compare the risk during periods of medication with the risk during nonmedication period within the same individual with epilepsy. We adjusted for civil status, employment, education, living area, psychiatric disorders prior to the start of follow-up, and psychotropic medication.
RESULTSCompared to matched controls, individuals with epilepsy were at increased risk of serious transport accidents (hazard ratio [HR] 1.37; 95% confidence interval [CI] 1.29–1.46). There were increased risks of pedestrian accidents (HR 2.24, 95% CI 1.69–2.97), bicycle accidents (HR 1.68, 95% CI 1.49–1.89) and car accidents (HR 1.31, 95% CI 1.19–1.44). However, among patients with a diagnosis of epilepsy, use of antiepileptic drugs did not influence the risk of serious transport accidents in population-level comparisons (HR 0.97; 95% CI 0.85–1.11) or within-individual comparisons (HR 0.99; 95% CI 0.69–1.42).
CONCLUSIONSerious transportation accidents were more common in individuals with epilepsy, but this risk was independent of use of antiepileptic drugs.</description><subject>Accidents, Traffic</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Anticonvulsants - therapeutic use</subject><subject>Cohort Studies</subject><subject>Emergency Medical Services</subject><subject>Epilepsy - epidemiology</subject><subject>Epilepsy - therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Mental Disorders - epidemiology</subject><subject>Middle Aged</subject><subject>Psychotropic Drugs - therapeutic use</subject><subject>Risk</subject><subject>Socioeconomic Factors</subject><subject>Sweden</subject><subject>Young Adult</subject><issn>0028-3878</issn><issn>1526-632X</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNp9kltv0zAUxy0EYmXwDRDKIw_L8DV2eECqxgZIFbxwfbJc56Q1S-NgO1T99nNoqTYkZsmyfc7vXGz_EXpO8DmhhL769nFxjm8NQQl-gGZE0KqsGP3-EM0wpqpkSqoT9CTGnxhnp6wfoxNa8xrXhM7Qj8vBdTDE3Vlh-uTgzyk5WzRhXMXJ2BQRgvNjLFIwfRx8SIWx1jXQp_i6mBe9Sc7322worF9P7pjGZvcUPWpNF-HZYT1FX64uP1-8Lxef3n24mC9KyyXDZW2BMKYUlYwqAVJhWS-5wJJjsFJxKwxrpaDMVEtG25pwARa3S15L01qQ7BSV-7xxC8O41ENwGxN22hunD6brvAOdr0w4yfzZf_m37utc-7DKc9SV4orcm_6Id27URGCGeebf7PkMb6Cx-ZWC6e6E3fX0bq1X_rcWSuGKTfd5eUgQ_K8RYtIbFy10nekh_4KmGNdC5lpTb3yP2uBjDNAeyxCsJ5HoLBL9r0hy2IvbLR6D_qoiA2oPbH2XIMTrbtxC0GswXVrfn_sGwVzLBA</recordid><startdate>20180327</startdate><enddate>20180327</enddate><creator>Sundelin, Heléne E.K</creator><creator>Chang, Zheng</creator><creator>Larsson, Henrik</creator><creator>Lichtenstein, Paul</creator><creator>Almqvist, Catarina</creator><creator>Tomson, Torbjörn</creator><creator>Ludvigsson, Jonas F</creator><general>American Academy of Neurology</general><general>Lippincott Williams & Wilkins</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>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DG8</scope><scope>D91</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20180327</creationdate><title>Epilepsy, antiepileptic drugs, and serious transport accidents: A nationwide cohort study</title><author>Sundelin, Heléne E.K ; Chang, Zheng ; Larsson, Henrik ; Lichtenstein, Paul ; Almqvist, Catarina ; Tomson, Torbjörn ; Ludvigsson, Jonas F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4730-9ce13388273285e78079b450740ec784c5a3f7523a6b32f9145ec0fb497afce73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Accidents, Traffic</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Anticonvulsants - therapeutic use</topic><topic>Cohort Studies</topic><topic>Emergency Medical Services</topic><topic>Epilepsy - epidemiology</topic><topic>Epilepsy - therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Mental Disorders - epidemiology</topic><topic>Middle Aged</topic><topic>Psychotropic Drugs - therapeutic use</topic><topic>Risk</topic><topic>Socioeconomic Factors</topic><topic>Sweden</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sundelin, Heléne E.K</creatorcontrib><creatorcontrib>Chang, Zheng</creatorcontrib><creatorcontrib>Larsson, Henrik</creatorcontrib><creatorcontrib>Lichtenstein, Paul</creatorcontrib><creatorcontrib>Almqvist, Catarina</creatorcontrib><creatorcontrib>Tomson, Torbjörn</creatorcontrib><creatorcontrib>Ludvigsson, Jonas F</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Linköpings universitet</collection><collection>SWEPUB Örebro universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sundelin, Heléne E.K</au><au>Chang, Zheng</au><au>Larsson, Henrik</au><au>Lichtenstein, Paul</au><au>Almqvist, Catarina</au><au>Tomson, Torbjörn</au><au>Ludvigsson, Jonas F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epilepsy, antiepileptic drugs, and serious transport accidents: A nationwide cohort study</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2018-03-27</date><risdate>2018</risdate><volume>90</volume><issue>13</issue><spage>e1111</spage><epage>e1118</epage><pages>e1111-e1118</pages><issn>0028-3878</issn><issn>1526-632X</issn><eissn>1526-632X</eissn><abstract>OBJECTIVESTo investigate the association between epilepsy and antiepileptic drugs and serious transport accidents requiring emergency care or resulting in death.
METHODSWe identified 29,220 individuals 18 years or older with epilepsy without cerebral palsy or intellectual disability and 267,637 matched controls using Swedish registers. This nationwide cohort was followed from 2006 to 2013 for serious transport accidents. We used Cox regression to analyze the risk of serious transport accidents between individuals with epilepsy and matched controls, and then stratified Cox regression to compare the risk during periods of medication with the risk during nonmedication period within the same individual with epilepsy. We adjusted for civil status, employment, education, living area, psychiatric disorders prior to the start of follow-up, and psychotropic medication.
RESULTSCompared to matched controls, individuals with epilepsy were at increased risk of serious transport accidents (hazard ratio [HR] 1.37; 95% confidence interval [CI] 1.29–1.46). There were increased risks of pedestrian accidents (HR 2.24, 95% CI 1.69–2.97), bicycle accidents (HR 1.68, 95% CI 1.49–1.89) and car accidents (HR 1.31, 95% CI 1.19–1.44). However, among patients with a diagnosis of epilepsy, use of antiepileptic drugs did not influence the risk of serious transport accidents in population-level comparisons (HR 0.97; 95% CI 0.85–1.11) or within-individual comparisons (HR 0.99; 95% CI 0.69–1.42).
CONCLUSIONSerious transportation accidents were more common in individuals with epilepsy, but this risk was independent of use of antiepileptic drugs.</abstract><cop>United States</cop><pub>American Academy of Neurology</pub><pmid>29490912</pmid><doi>10.1212/WNL.0000000000005210</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Neurology, 2018-03, Vol.90 (13), p.e1111-e1118 |
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| source | MEDLINE; Alma/SFX Local Collection; SWEPUB Freely available online; Journals@Ovid Complete |
| subjects | Accidents, Traffic Adolescent Adult Anticonvulsants - therapeutic use Cohort Studies Emergency Medical Services Epilepsy - epidemiology Epilepsy - therapy Female Follow-Up Studies Humans Male Mental Disorders - epidemiology Middle Aged Psychotropic Drugs - therapeutic use Risk Socioeconomic Factors Sweden Young Adult |
| title | Epilepsy, antiepileptic drugs, and serious transport accidents: A nationwide cohort study |
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