Epilepsy related deaths in Queensland, a population based study

Clark, Damian R. and Riney, K. (2009). Epilepsy related deaths in Queensland, a population based study. In: Special Issue: Abstracts from the 2009 Annual Meeting of the American Epilepsy Society. 2009 Annual Meeting of the American Epilepsy Society, Boston, MA, United States, (304-305). 4-8 December 2009. doi:10.1111/j.1528-1167.2009.02377_3.x

Author Clark, Damian R.
Riney, K.
Title of paper Epilepsy related deaths in Queensland, a population based study
Conference name 2009 Annual Meeting of the American Epilepsy Society
Conference location Boston, MA, United States
Conference dates 4-8 December 2009
Proceedings title Special Issue: Abstracts from the 2009 Annual Meeting of the American Epilepsy Society   Check publisher's open access policy
Journal name Epilepsia   Check publisher's open access policy
Place of Publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Publication Year 2009
Sub-type Poster
DOI 10.1111/j.1528-1167.2009.02377_3.x
ISSN 0013-9580
Volume 50
Issue Supp. 11
Start page 304
End page 305
Total pages 2
Language eng
Formatted Abstract/Summary
Rationale: Patients with epilepsy have an excess mortality that is 2-3 times that of the general population and the rate of epilepsy related death is a key indicator of the epilepsy care provided by health services. To date, there has been no published population based data on epilepsy related deaths in Queensland, a state in Australia where a state-wide Paediatric Epilepsy Network is currently being established. Reducing epilepsy related deaths would be a key outcome of a state-wide network; therefore it is important that there is current data on epilepsy related death for the Queensland population.

Methods: A search was performed of all death certificates for Queensland for death related to epilepsy in the five year period January 2004 to December 2008. A search was also undertaken of all Queensland Coroner's post-mortem reports for the same time period where the word ‘epilepsy’ or ‘seizure’ was contained within the body of the report. These post-mortem reports were then reviewed and compared to the data available from death certificates. In addition, a previously published audit tool was used to assess whether autopsies in those that had epilepsy related death had been performed in accordance with published recommendations.

Results: During this five year period, a total of 244 people (2M:F) were certified to have died from epilepsy, of which 12 (5%) were certified to have died from status epilepticus. Estimating a population incidence of epilepsy of 2% within the  Queensland population, the population based epilepsy related death rate was 0.6 deaths per 1000 people with epilepsy per year. During the same time period 126 people had post-mortem reports that indicated the death was related to epilepsy, indicating that only 52% of all deaths certified as related to epilepsy have post-mortem examination in Queensland (n=126, 1.3M:F, median age 34 years). In the subgroup of patients with epilepsy related death who had post-mortem, causes of death included aspiration (n=11, 9%), status epilepticus (n=3, 2%), and possible SUDEP (n=112, 88%). Whilst the Coroner's report did not categorize people with epilepsy who died of trauma or suicide as death related to epilepsy, this data was available. In the same time period 27 patients with epilepsy died from trauma (drowning, driver in a road traffic accident), 39 from suicide and in 17 people with epilepsy who died, the cause of death could not be determined (frequently due to body decomposition). Published recommendations indicate that where cause of death is unexplained at post-mortem (possible SUDEP) that full neuropathological examination of the brain, toxicology and histological examination of major organs takes place. However, these post-mortem investigations were undertaken in only 64/112 (58%) cases where the cause of death was unexplained.

Conclusions: This is the first population based study of epilepsy related death in Queensland and demonstrates that rates of epilepsy related death are comparable to those found in other studies(Hanna et al. 2002). Data from this study will inform the strategic direction of a state-wide Paediatric Epilepsy Network for Queensland.
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Non-UQ

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Created: Sun, 10 Jan 2010, 00:06:37 EST