Cause-specific mortality in adults with unprovoked seizures - A population-based incidence cohort study

Purpose: To determine the cause-specific mortality relative to that expecte d in a population-based incidence cohort of people with unprovoked seizures . Methods: The cohort comprises 224 inhabitants of Iceland first diagnosed as suffering from unprovoked seizures during a 5-year period from 1960 to 1 964. The expected number of deaths was calculated by multiplying person-yea rs of observation within 5-year age categories for each year from diagnosis through 1995 by cause-specific and sex-specific national death rates for t hose aged 20 years and above. The standardized mortality ratio (SMR) and 95 % confidence intervals (95% CI) were calculated. Results: All-cause mortali ty was increased among men (SMR 2.25, 95% Cl 1.56-3.14) but not women (SMR 0.79, 95% CI 0.38-1.46). Among men, there were 8 deaths from accidents, poi soning and violence observed versus 2.82 expected (SMR 2.84, 95% CI 1.22-5. 59) and 4 deaths from suicide versus 0.69 expected (SMR 5.80, 95% CI 1.56-1 4.84). All-cause mortality for men was still elevated after restriction of analysis to those with seizures of unknown etiology (SMR 1.73, 95% CI 1.05- 2.67) with the excess deaths attributable to suicide (SMR 5.26, 95% CI 1.06 -15.38). Both males and females with remote symptomatic unprovoked seizures had an increase in all-cause mortality due to excess mortality from all ca ncers, cerebrovascular disease and accidents. Conclusion: When compared wit h the age-, time-period- and gender-specific mortality in the general popul ation, there is excess mortality in men but not women. The increased mortal ity for men is partly attributable to excess mortality from accidents and s uicides. Copyright (C) 2001 S. Karger AG, Basel.