Association Between Generalized Tonic-Clonic Seizure and Cardiopulmonary Risk
Abstract number :
972
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2020
Submission ID :
2423305
Source :
www.aesnet.org
Presentation date :
12/7/2020 1:26:24 PM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Takafumi Kubota, University Hospitals of Cleveland Medical Center; Takahiro Tsushima - University Hospitals of Cleveland Medical Center; Guadalupe Fernandez-Baca Vaca - University Hospitals of Cleveland Medical Center;;
Rationale:
Generalized tonic-clonic seizure (GTCS) is a significant risk factor for sudden unexpected death in epilepsy (SUDEP). It is suggested postictal cardiopulmonary dysfunction can cause SUDEP in patients with epilepsy (PWE) but the exact association between GTCS and pre-existing cardiopulmonary comorbidities is not well understood. The aim of this study is to evaluate the prevalence of cardiopulmonary diseases in PWE with or without GTCS.
Method:
We used a cloud-based aggregated electronic medical records from over 64 million unique patients in the US (Explorys, IBM Watson). We identified PWE (0-65 years) with or without GTCS from January 1999 to June 2020.
Results:
Out of 512,790 PWE, 80,970 had GTCS. Compared to PWE without GTCS, GTCS was significantly associated with cardiovascular diseases (odds ratio [OR] 1.08; 95% confidence interval [CI] 1.06-1.10, P< 0.001) such as hypertension (OR 1.30; 95% CI 1.26-1.33, P< 0.001), heart failure (OR 1.06; 95% CI 1.03-1.09, P< 0.001), atrioventricular block (OR 1.26; 95% CI 1.17-1.35, P< 0.001), cardiogenic shock (OR 1.50; 95% CI 1.36-1.66, P< 0.001), ventricular tachycardia (OR 1.26 95% CI 1.18-1.35, P< 0.001), ventricular fibrillation (OR 1.67; 95% CI 1.49-1.86, P< 0.001), and cardiac arrest (OR 1.83; 95% CI 1.75-1.91, P< 0.001). PWE with GTCS was also related to pulmonary diseases (OR 1.26; 95% CI 1.24-1.28, P< 0.001) such as obstructive sleep apnea syndrome (OR 1.13; 95% CI 1.10-1.15, P< 0.001), central sleep apnea syndrome (OR 1.24; 95% CI 1.10-1.41, P=0.001), pneumonia (OR 1.39; 95% CI 1.37-1.42, P< 0.001), pneumothorax (OR 1.26; 95% CI 1.18-1.36, P< 0.001), pulmonary edema (OR 1.31; 95% CI 1.23-1.39, P< 0.001), and acute respiratory distress syndrome (OR 1.50; 95% CI 1.34-1.69, P< 0.001).
Conclusion:
In this large population-based study, PWE with GTCS had significantly high prevalence of cardiopulmonary diseases. These comorbidities may contribute to SUDEP in PWE with GTCS. The utility of cardiopulmonary screening in PWE needs to be investigated.
Funding:
:None.
Comorbidity