Epilepsy-related injuries – The role of seizure profile, somatic comorbidities and adverse medication effects

• Published in: Epilepsy & behavior 2024-08, Vol.157, p.109907, Article 109907
• Main Authors: Puteikis, Kristijonas, Jasionis, Arminas, Mameniškienė, Rūta
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anticonvulsants - adverse effects; Anticonvulsants - therapeutic use; Comorbidity; Cross-Sectional Studies; Epilepsy; Epilepsy - drug therapy; Epilepsy - epidemiology; Female; Hospitalization - statistics & numerical data; Humans; Injury; Male; Middle Aged; Morbidity; Mortality; Seizures; Seizures - epidemiology; Trauma; Wounds and Injuries - complications; Wounds and Injuries - epidemiology; Young Adult
• ISSN: 1525-5050; 1525-5069; 1525-5069
• DOI: 10.1016/j.yebeh.2024.109907

•Determinants of hospitalization because of epilepsy-related injuries (ERIs) remain relatively unknown.•One in four people with epilepsy having suffered ERIs required in-hospital treatment.•Medication effects and comorbidities were independently associated with ERI-linked hospitalisations.•New seizure-unrelated factors increasing the risk of serious ERIs should be explored. While epilepsy-related injuries (ERIs) are frequent in people with epilepsy (PWE), factors associated with hospitalization because of ERIs remain relatively unknown. We conducted a cross-sectional anonymous survey at a tertiary epilepsy clinic among adult outpatients with epilepsy. Participants indicated their demographic, clinical characteristics, adverse effects of antiseizure medications (ASMs), somatic comorbidities and whether they were hospitalized because of ERIs in the past. For variables with significantly different distributions between participant subgroups (positive vs negative history of past hospitalisation because of ERI), the association with ERI-linked hospitalization was assessed using univariable and multivariable regression models. Among 600 PWE (312, 52.0 % female) included, 405 (67.5 %) reported at least one ERI in the past and 104 (25.7 %) had been hospitalised because of at least one of the injuries. Age, seizures in the street, focal unaware seizures and adverse ASM effects were associated with ERI-linked hospitalization only in univariable regression models. Male sex (OR = 1.677, 95 % CI = 1.022–2.753), loss of consciousness during seizures (OR = 2.294, 95 % CI = 1.166–4.513), seizure frequency (OR = 1.264, 95 % CI = 1.024–1.559) and ASM-related loss of coordination (OR = 3.496, 95 % CI = 1.670–7.320) were statistically significant predictors in the multivariable model (Nagelkerke R2 = 0.106). Our study indicates that, beyond seizure-related factors, adverse effects of ASMs and somatic comorbidities need to be considered when estimating the odds of previous ERI-linked hospitalisations. Alternative determinants of a higher risk of serious ERI, such as lifestyle or occupational variables, should be explored in the future.