Sudden unexpected death in epilepsy: Assessing the public health burden

Summary Objective There is not yet a clear consensus on the incidence of sudden unexpected death in epilepsy (SUDEP) or the extent of its burden on public health. In this systematic review, we seek to summarize the incidence of SUDEP and its age distribution, as well as the years of potential life l...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2014-10, Vol.55 (10), p.1479-1485
Main Authors: Thurman, David J., Hesdorffer, Dale C., French, Jacqueline A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
Child
Child, Preschool
Cost of Illness
Death, Sudden - epidemiology
Death, Sudden - etiology
Epilepsy
Epilepsy - mortality
Health risk assessment
Humans
Incidence
Infant
Infant, Newborn
Life Expectancy
Middle Aged
Public health
Risk Factors
Sudden death
Systematic review
Young Adult
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Summary:Summary Objective There is not yet a clear consensus on the incidence of sudden unexpected death in epilepsy (SUDEP) or the extent of its burden on public health. In this systematic review, we seek to summarize the incidence of SUDEP and its age distribution, as well as the years of potential life lost and cumulative risks of SUDEP for persons with epilepsy. Methods We conducted a systematic search for epidemiologic studies of sudden death in epilepsy and rated their quality of evidence. We pooled data from comparable higher quality population‐based studies of SUDEP incidence across all age groups, calculating the overall incidence of SUDEP per 100,000 population, and per 1,000 people with epilepsy. Using standard formulas, we also calculated the years of potential life lost and cumulative risks associated with SUDEP. Results SUDEP has an estimated overall crude annual incidence rate of 0.81 cases per 100,000 population, or 1.16 cases per 1,000 patients with epilepsy. Comparing years of potential life lost from SUDEP with selected other neurologic diseases, SUDEP ranks second only to stroke. Significance Despite limitations to the data on which our analysis is based, we conclude that the public health burden of SUDEP, which has previously been underappreciated, is substantial and deserves much more attention from clinicians, researchers, and the public health community. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
ISSN:0013-9580
1528-1167
DOI:10.1111/epi.12666