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Epilepsy, antiepileptic drugs, and serious transport accidents A nationwide cohort study
Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.ORCID iD: 0000-0002-8189-4098
Karolinska Inst, Sweden.
Karolinska Inst, Sweden.
Karolinska Inst, Sweden.
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2018 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 90, no 13, p. E1111-+Article in journal (Refereed) Published
Abstract [en]

Objectives To investigate the association between epilepsy and antiepileptic drugs and serious transport accidents requiring emergency care or resulting in death.

Methods We 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.

Results Compared 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).

Conclusion Serious transportation accidents were more common in individuals with epilepsy, but this risk was independent of use of antiepileptic drugs.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2018. Vol. 90, no 13, p. E1111-+
National Category
Geriatrics
Identifiers
URN: urn:nbn:se:liu:diva-150304DOI: 10.1212/WNL.0000000000005210ISI: 000439102000003PubMedID: 29490912OAI: oai:DiVA.org:liu-150304DiVA, id: diva2:1239490
Note

Funding Agencies|Swedish Research Council for Health, Working Life and Welfare [2014-2780, 2012-1678]; Swedish Research Council [2014-3831, 2011-2492]; Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM) [340-2013-5867]; Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM): Stockholm County Council (ALF) [340-2013-5867TT]

Available from: 2018-08-16 Created: 2018-08-16 Last updated: 2019-05-01Bibliographically approved

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Sundelin, Heléne

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Division of Children's and Women's healthFaculty of Medicine and Health SciencesH.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus
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