Association of Levels of Specialized Care With Risk of Premature Mortality in Patients With Epilepsy.

JAMA Neurology
Mark LowerisonSamuel Wiebe

Abstract

Patients with epilepsy are at an elevated risk of premature mortality. Interventions to reduce this risk are crucial. To determine if the level of care (non-neurologist, neurologist, or comprehensive epilepsy program) is negatively associated with the risk of premature mortality. In this retrospective open cohort study, all adult patients 18 years or older who met the administrative case definition for incident epilepsy in linked databases (Alberta Health Services administrative health data and the Comprehensive Calgary Epilepsy Programme Registry [CEP]) inclusive of the years 2002 to 2016 were followed up until death or loss to follow-up. The final analyses were performed on May 1, 2019. Evaluation by a non-neurologist, neurologist, or epileptologist. The outcome was all-cause mortality. We used extended Cox models treating exposure to a neurologist or the CEP as time-varying covariates. Age, sex, socioeconomic deprivation, disease severity, and comorbid burden at index date were modeled as fixed-time coefficients. A total 23 653 incident cases were identified (annual incidence of 89 per 100 000); the mean age (SD) at index date was 50.8 (19.1) years and 12 158 (50.3%) were women. A total of 14 099 (60%) were not exposed to sp...Continue Reading

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Citations

Feb 18, 2020·JAMA Neurology·Colin B Josephson, Samuel Wiebe
Feb 18, 2020·JAMA Neurology·Mamta Bhushan SinghVictor Patterson
Apr 10, 2020·Expert Review of Neurotherapeutics·Max Christian PenselRainer Surges
Apr 7, 2020·JAMA Neurology
Nov 19, 2020·Epilepsia·Colin B Josephson, Samuel Wiebe
Jul 20, 2021·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Sándor BeniczkyEugen Trinka
Oct 31, 2021·Nature Reviews. Neurology·Roland D ThijsRainer Surges
Oct 20, 2020·Seizure : the Journal of the British Epilepsy Association·Arunmozhimaran ElavarasiM V Padma

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