Mortality in patients with epilepsy: a systematic review.

Abstract

Background: Epilepsy is linked to a significantly higher risk of death, yet public awareness remains low. This study aims to investigate mortality characteristics, to reduce epilepsy-related deaths and improve prevention strategies.

Methods: This study systematically reviews mortality data in relevant literature from PubMed and Embase up until June 2024. Data quality is assessed using the Newcastle-Ottawa Scale, and analysis includes trends, regional differences, and the economic impact of premature death. Global Burden of Disease (GBD) data are used to validate trends. In addition, a review of guidelines and expert statements on sudden unexpected death in epilepsy (SUDEP) is included to explore intervention strategies and recommendations.

Results: Annual mortality rates of epilepsy have gradually declined, mainly due to improvements in low-income countries, while high-income regions have experienced an upward trend. Male patients exhibit higher mortality rates than females. Age-based analysis shows that the elderly contributes most to this increase due to chronic conditions such as cardiovascular disease and pneumonia related to epilepsy. This may be a key factor contributing to the increased mortality among epilepsy patients in aging high-income regions. Accidents and suicides are more prevalent in low-income regions. The highest mortality risks occur in the early years post-diagnosis and during prolonged, uncontrolled epilepsy. SUDEP remains a leading cause of death.

Conclusion: This study highlights the impact of gender, region, and disease duration on epilepsy mortality. Future research should focus on elderly epilepsy patients mortality characteristics and personalized interventions for SUDEP.