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Epilepsy, antiepileptic drugs, and serious transport accidents: A nationwide cohort study
Department of Pediatrics, Linköping University Hospital, Linköping, Sweden.ORCID iD: 0000-0002-8189-4098
Departments of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Departments of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-6851-3297
Departments of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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2018 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 90, no 13, p. E1111-+Article in journal (Refereed) Published
Abstract [en]

Objectives: To investigate the association between epilepsy and antiepileptic drugs and serious transport accidents requiring emergency care or resulting in death.

Methods: We identified 29,220 individuals 18 years or older with epilepsy without cerebral palsy or intellectual disability and 267,637 matched controls using Swedish registers. This nationwide cohort was followed from 2006 to 2013 for serious transport accidents. We used Cox regression to analyze the risk of serious transport accidents between individuals with epilepsy and matched controls, and then stratified Cox regression to compare the risk during periods of medication with the risk during nonmedication period within the same individual with epilepsy. We adjusted for civil status, employment, education, living area, psychiatric disorders prior to the start of follow-up, and psychotropic medication.

Results: Compared to matched controls, individuals with epilepsy were at increased risk of serious transport accidents (hazard ratio [HR] 1.37; 95% confidence interval [CI] 1.29-1.46). There were increased risks of pedestrian accidents (HR 2.24, 95% CI 1.69-2.97), bicycle accidents (HR 1.68, 95% CI 1.49-1.89) and car accidents (HR 1.31, 95% CI 1.19-1.44). However, among patients with a diagnosis of epilepsy, use of antiepileptic drugs did not influence the risk of serious transport accidents in population-level comparisons (HR 0.97; 95% CI 0.85-1.11) or within-individual comparisons (HR 0.99; 95% CI 0.69-1.42).

Conclusion: Serious transportation accidents were more common in individuals with epilepsy, but this risk was independent of use of antiepileptic drugs.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018. Vol. 90, no 13, p. E1111-+
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-68481DOI: 10.1212/WNL.0000000000005210ISI: 000439102000003PubMedID: 29490912OAI: oai:DiVA.org:oru-68481DiVA, id: diva2:1239020
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-2780 2012-1678Swedish Research Council, 2014-3831 2011-2492
Note

Funding Agencies:Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM)  340-2013-5867 

Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM): Stockholm County Council (ALF)  340-2013-5867TT 

Available from: 2018-08-15 Created: 2018-08-15 Last updated: 2019-01-24Bibliographically approved

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Larsson, HenrikLudvigsson, Jonas F.

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