099 A retrospective study of mortality rates in a video-EEG telemetry patient cohort

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY(2019)

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摘要
Rationale Despite emerging evidence of altered brain connectivity patterns in patients with non-epileptic attack disorder (NEAD), studies on the mortality rates in these patients remain scarce. Methods Mortality data was studied retrospectively in a cohort of patients admitted for video-telemetry evaluation at the Manchester Centre for Clinical Neurosciences from 2009 to 2019. The diagnosis of NEAD, epilepsy or both was confirmed by the consensus opinion of experienced epileptologists. Mortality and cause of death were identified from the death alert system linked to the Electronic Patient Record and from coroners’ reports, where available. Results Out of 693 patients 662 were included in the study analyses. Death was registered in 23 patients, 82.6% of whom suffered with epilepsy and 17.4% with NEAD. In epilepsy patients, sudden unexpected death was recorded in 42.1%, death from other medical conditions in 52.6% and death from external causes - in 5.3%. In the NEAD group, the causes of death included iatrogenic and other medical conditions. Conclusions Mortality rates in the NEAD group of patients are not negligible. With NEAD patients being at risk of unnecessary iatrogenic interventions, increased awareness of the heightened mortality rates in this patient cohort could avert preventable deaths.
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