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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。
Objective To investigate the long-term mortality risk of community-based epilepsy patients and analyze the related factors. Methods A total of 65 cases of epilepsy diagnosed during the investigation of Huashan Hospital and Institute of Neurology, Fudan University in 2002 in Luxiang Town, Jinshan District, Shanghai were followed up by face-to-face interviews in 2014 (12 years from the baseline survey) The investigators collected information, fill in the follow-up questionnaire to analyze the long-term prognosis of patients. Results The survey completed a total of 60 cases, 5 cases were lost to follow-up (loss rate of 7.7%). A total of 11/60 deaths were found, with a case fatality rate of 18.3% (95% CI: 10.0-29.6). Tumors were the leading cause of death, accounting for 27.3% of all causes of death. The standardized death rate (SMR) was 2.6 (95% CI: 1.4-4.5) with the highest SMR among all age groups 40-45 (8.9). COX proportional hazards regression model analysis showed that partial epileptic seizures (HR = 5.4, 95% CI: 1.2-24.0) were independent risk factors for death in patients. Conclusion The risk of death from epilepsy in this community is 2.6 times that of the general population, and the tumor is the leading cause of death.