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PURPOSE: We studied overall and cause-specific mortality rates in a large cohort of patients with epilepsy compared with mortality rates of the general population in the same geographic area. METHODS: The cohort consisted of all patients (N = 9,061) aged > 15 years admitted with a diagnosis of epilepsy for inpatient care in Stockholm during the years 1980-1989. All patients were followed in the National Cause-of-Death Register, from which the causes of death were obtained, until December 31, 1992. Thus, 53,520 person-years were observed. Mortality rates were compared with those of the general population of Stockholm. RESULTS: We observed 4,001 deaths in the cohort, compared with an expected number of 1,109 deaths in the general population. This yielded a standardized mortality ratio (SMR) of 3.6 95% confidence interval (CI) 3.5-3.7. Although highest in the younger patients, the SMR was significantly increased in all age groups. The excess mortality rate in the cohort was due to a wide range of causes of death, including malignant neoplasms SMR 2.6 (2.4-2.8), diseases of the circulatory system, SMR 3.1 (3.0-3.3), diseases of the respiratory system SMR 4.0 (3.6-4.5), diseases of the digestive system SMR 5.1 (4.4-5.8), and injuries and poisoning SMR 5.6 (5.0-6.3). CONCLUSIONS: Our results demonstrate that this large subgroup of patients with a diagnosis of epilepsy, once hospitalized and discharged, is a population at risk, with an excess mortality rate due to several different causes.
Nilsson et al. (Wed,) studied this question.