Abstracts

Rationale: The National General Practice Study of Epilepsy (NGPSE) was set up in 1984 and is one of the longest established community-based studies of epilepsy in existence. The study has followed 792 patients with definite or possible epilepsy and 220 with febrile seizures who were enrolled by their General Practitioners (GPs). Mortality data in the cohort were presented in 1994 and 2001. Methods: A long-term prospective community based study of an incident cohort of patients diagnosed with epilepsy or febrile convulsions in the early 1980s. All patients in the study are registered with the Office of National Statistics who send us a copy of the death certificate for all patients who have died since the start of the study. Results: At seven years of follow-up 150 deaths had occurred in those with definite or possible epilepsy and the Standardised Mortality Ratio (SMR) was 2.5 (95% CI 2.1 to 2.9). The SMR was highest in the first year after presentation (SMR 5.1). At 14 years of follow-up there were 199 deaths and the SMR was 2.1 (95% CI 1.8 to 2.4). Currently, after 24 years, 295 people have died, as well as one who presented with febrile seizures. Current analysis is focusing on the temporal pattern SMR, in particular to determine whether the downward trend observed in mortality continues or if, as has been suggested, there is late increase in mortality On primary analysis, the most frequent causes of death included pneumonia, cancer (eg brain, breast, lung, and bladder), myocardial infarction and stroke. There have been few reported epilepsy-related deaths - a further one in addition to the five already reported. Conclusions: This study continues to confirm the increased premature mortality in people with epilepsy. The community basis of the study is important to put this risk into perspective as it is often exaggerated in hospital-based studies.