社区癫患者的死亡风险(距基线调查12年后)随访研究

Mortality of People with Epilepsy in a Community-based Cohort in Jinshan District, Shanghai: A Follow-up after 12 Years

目的对社区癫患者进行随访,获得其长期的死亡风险,并对相关影响因素进行分析。方法对2002年复旦大学附属华山医院和神经病学研究所在上海市金山区吕巷镇调查时确诊的65例癫患者,于2014年（距基线调查时间12年）以面见方式进行随访,由调查者收集资料、填写随访问卷,分析患者的长期预后情况。结果完成调查共计60例,失访5例（失访率7.7%）。共发现死亡病例11/60例,病死率为18.3%（95%CI：10.0~29.6）;肿瘤是首要死因,占全部死因的27.3%。标化死亡比（SMR）为2.6（95%CI：1.4~4.5）,各年龄段中以40~45岁的SMR最高（8.9）。COX比例风险回归模型分析显示部分性癫发作（HR=5.4,95%CI：1.2~24.0）是患者死亡的独立危险因素。结论该社区癫患者的死亡风险是普通人群的2.6倍,肿瘤是首要死因。

Aim To conducted a follow up the people with epilepsy（PWE） diagnosed in the prevalence study in Shanghai Jinshan District 12 years ago to observe the mortality of PWE. Methods A face-to-face interview to follow up the 65 PWE diagnosed in the prevalence study in Jinshan District, Shanghai, 2002 were carried out in 2014. Results 11 death cases were found in the cohort. The case fatality was 18.3%（95%CI 10.0-29.6）. Tumor was the most common cause of death in the cohort, accounting for 27.3% of all death. The overall standardized mortality rate（SMR） was 2.56（95%CI： 1.35-4.45）. PWE with 40 to 45 years old suffered the highest SMR among all the age groups. COX regression analysis indicated that partial seizure was an independent risk factor for death（HR 5.40, 95%CI： 1.21-24.04） in the present cohort. Conclusion The risk of death among PWE was 2.56 times higher than general population in the present study. Tumor was the most common cause of death in the cohort.