| アブストラクト | Objectives: The risk of dying by alcohol-specific causes in people with epilepsy has seldom been reported from population-based studies. We aimed to estimate the relative risk of alcohol-specific mortality in people with epilepsy, and the extent to which problematic alcohol use was previously identified in the patients' medical records. Method: We delineated cohort studies in two population-based datasets, the Clinical Practice Research Datalink (CPRD GOLD) in England (January 01, 2001-December 31, 2014) and the Secure Anonymised Information Linkage (SAIL) Databank in Wales (January 01, 2001-December 31, 2014), linked to hospitalization and mortality records. People with epilepsy were matched to up to 20 persons without epilepsy on gender, age (+/-2 years) and registered general practice. We identified alcohol-specific death from Office for National Statistics (ONS) records using specified ICD-10 codes. We further identified prescriptions, interventions and hospitalisations related to alcohol use. Results: In the CPRD GOLD, we identified 9,871 individuals in the incident epilepsy cohort and 185,800 in the comparison cohort and, in the SAIL Databank, these numbers were 5,569 and 110,021, respectively. We identified a five-fold increased risk of alcohol-specific mortality in people with epilepsy vs. those without the condition in our pooled estimate across the two datasets (deprivation-adjusted HR 4.85, 95%CI 3.46-6.79). Conclusions: People with epilepsy are at increased risk of dying by an alcohol-specific cause than those without the disorder. It is plausible that serious alcohol misuse could either contribute to the development of epilepsy or it could commence subsequent to epilepsy being diagnosed. Regardless of the direction of the association, it is important that the risk of dying as a consequence of alcohol misuse is accurately quantified in people affected by epilepsy. Systematically-applied, sensitive assessment of alcohol consumption by healthcare professionals, at opportunistic, clinical contacts, with rapid access to quality treatment services, should be mandatory and play a key role in reduction of health harms and mortality. |
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| ジャーナル名 | Frontiers in neurology |
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| 投稿日 | 2021/2/9 |
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| 投稿者 | Gorton, Hayley C; Webb, Roger T; Parisi, Rosa; Carr, Matthew J; DelPozo-Banos, Marcos; Moriarty, Kieran J; Pickrell, W Owen; John, Ann; Ashcroft, Darren M |
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| 組織名 | School of Applied Sciences, University of Huddersfield, Huddersfield, United;Kingdom.;NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester;Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester,;United Kingdom.;Division of Psychology & Mental Health, Centre for Mental Health and Safety,;Manchester Academic Health Sciences Centre (MAHSC), Faculty of Biology, Medicine;and Health, School of Health Sciences, University of Manchester, Manchester,;Division of Informatics, Imaging & Data Sciences, Manchester Academic Health;Sciences Centre (MAHSC), Faculty of Biology, Medicine and Health, School of;Health Sciences, University of Manchester, Manchester, United Kingdom.;Centre for Pharmacoepidemiology and Drug Safety, Manchester Academic Health;Farr Institute, Swansea University Medical School, Swansea, United Kingdom.;Bolton NHS Foundation Trust, Bolton, United Kingdom.;Neurology and Molecular Neuroscience Research Group, Swansea University Medical;School, Swansea University, Swansea, United Kingdom.;Neurology Department, Morriston Hospital, Swansea Bay University Health Board,;Swansea, United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33551978/ |
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