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Incidence of First-Episode Status Epilepticus and Risk Factors in Ontario, Canada

Published online by Cambridge University Press:  05 February 2024

R. Grace Couper Open the ORCID record for R. Grace Couper [Opens in a new window] ,
Tresah C. Antaya Open the ORCID record for Tresah C. Antaya [Opens in a new window] ,
Piotr Wilk Open the ORCID record for Piotr Wilk [Opens in a new window] ,
Teneille Gofton Open the ORCID record for Teneille Gofton [Opens in a new window] ,
Derek B. Debicki Open the ORCID record for Derek B. Debicki [Opens in a new window]  and
Jorge G. Burneo Open the ORCID record for Jorge G. Burneo [Opens in a new window]
R. Grace Couper
Affiliation:
Neuroepidemiology Research Unit, Department of Clinical Neurological Sciences, Western University, London, ON, Canada
Tresah C. Antaya
Affiliation:
Neuroepidemiology Research Unit, Department of Clinical Neurological Sciences, Western University, London, ON, Canada Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
Piotr Wilk
Affiliation:
Department of Epidemiology and Biostatistics, Western University, London, ON, Canada Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada ICES Western, London, ON, Canada Departments of Epidemiology, Maastricht University, Maastricht, The Netherlands
Teneille Gofton
Affiliation:
Department of Clinical Neurological Sciences, Western University, London, ON, Canada
Derek B. Debicki
Affiliation:
Department of Clinical Neurological Sciences, Western University, London, ON, Canada
Jorge G. Burneo*
Affiliation:
Neuroepidemiology Research Unit, Department of Clinical Neurological Sciences, Western University, London, ON, Canada Department of Epidemiology and Biostatistics, Western University, London, ON, Canada ICES Western, London, ON, Canada Department of Clinical Neurological Sciences, Western University, London, ON, Canada
*
Corresponding author: J. G. Burneo; Email: jburneo2@uwo.ca
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Abstract

Background:

Status epilepticus (SE) is a neurological emergency characterized by prolonged seizures. However, the incidence of first-episode SE is unclear, as estimates vary greatly among studies. Additionally, SE risk factors have been insufficiently explored. Therefore, the objectives of this study were to estimate the incidence of first-episode SE in Ontario, Canada, and estimate the associations between potential sociodemographic and health-related risk factors and first-episode SE.

Methods:

We conducted a population-based retrospective cohort study using linked health administrative datasets. We included individuals who completed Canada’s 2006 Census long-form questionnaire, lived in Ontario, were between 18 and 105, and had no history of SE. A Cox proportional hazards regression model was used to estimate the hazard ratios for SE within three years associated with each potential risk factor.

Results:

The final sample included 1,301,700 participants, 140 of whom were hospitalized or had an emergency department visit for first-episode SE during follow-up (3.5 per 100,000 person-years). Older age was the only significant sociodemographic SE risk factor (HR = 1.35, 95% CI = 1.33, 1.37), while health-related risk factors included alcohol or drug abuse (HR = 1.05, 95% CI = 1.02, 1.08), brain tumour or cancer (HR = 1.14, 95% CI = 1.12, 1.15), chronic kidney disease (HR = 1.32, 95% CI = 1.29, 1.36), dementia (HR = 1.42, 95% CI = 1.36, 1.48), diabetes (HR = 1.11, 95% CI = 1.09, 1.12), epilepsy or seizures (HR = 1.05, 95% CI = 1.01, 1.09) and stroke (HR = 1.08, 95% CI = 1.05, 1.11).

Conclusion:

The estimated incidence of SE in a sample of Ontario residents was 3.5 per 100,000 person-years. Older age and several comorbid conditions were associated with higher first-episode SE risk.

Résumé

RÉSUMÉ

Incidence des premiers épisodes d’état de mal épileptique et facteurs de risque en Ontario (Canada)

Contexte :

L’état de mal épileptique (EME) est une urgence neurologique caractérisée par des crises convulsives prolongées. Cependant, l’incidence des premiers épisodes d’EME demeure méconnue dans la mesure où les estimations varient considérablement d’une étude à l’autre. En outre, les facteurs de risque de l’EME n’ont pas été suffisamment explorés. Par conséquent, les objectifs de cette étude étaient d’estimer l’incidence des premiers épisodes d’EME en Ontario (Canada) et d’estimer les associations entre ces mêmes premiers épisodes et des facteurs de risque sociodémographiques et liés à la santé.

Méthodes :

Nous avons ainsi mené une étude de cohorte rétrospective basée sur la population en utilisant des ensembles de données administratives liées à la santé. Nous avons inclus les individus ayant rempli le questionnaire détaillé du recensement canadien de 2006 qui vivaient en Ontario, qui avaient entre 18 et 105 ans et qui n’avaient pas d’antécédents d’EME. À cet égard, un modèle de régression des risques proportionnels de Cox a été utilisé pour estimer, sur une période de trois ans, les rapports de risque de l’EME associés à chaque facteur potentiel de risque.

Résultats :

Notre échantillon final comprenait 1 301 700 participants, dont 140 avaient été hospitalisés ou s’étaient rendus aux urgences en raison d’un premier épisode d’EME au cours d’un suivi (3,5 par 100 000 personnes-années). L’âge avancé d’un individu s’est révélé le seul facteur de risque sociodémographique significatif de l’EME (RRI = 1,35 ; IC 95 % = 1,33-1,37) tandis que les facteurs de risque liés à la santé ont inclus l’abus d’alcool ou de drogues (RRI = 1,05 ; IC 95 % = 1,02-1,08), la présence d’une tumeur cérébrale ou d’un cancer (RRI = 1,14 ; IC 95 % = 1,12-1,15), l’insuffisance rénale chronique (RRI = 1,32 ; IC 95 % = 1,29-1,36), la démence (RRI = 1,42 ; IC 95 % = 1,36-1,48), le diabète (RRI = 1,11 ; IC 95 % = 1,09-1,12), l’épilepsie ou des crises convulsives (RRI = 1,05 ; IC 95 % = 1,01-1,09) ainsi que les AVC (RRI = 1,08 ; IC 95 % = 1,05-1,11).

Conclusion :

L’incidence estimée de l’EME dans un échantillon de résidents de l'Ontario était de 3,5 par 100 000 années-personnes. De plus, l’âge avancé de ces résidents de même que plusieurs comorbidités ont été associés à un risque plus élevé d’être victime d’un premier épisode d’EME.

Keywords

EpidemiologyEpilepsyStatus epilepticus
Type
Original Article
Information
Canadian Journal of Neurological Sciences , First View , pp. 1 - 9
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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