The incidence of SUDEP

Neurology ◽  
2017 ◽  
Vol 89 (2) ◽  
pp. 170-177 ◽  
Author(s):  
Olafur Sveinsson ◽  
Tomas Andersson ◽  
Sofia Carlsson ◽  
Torbjörn Tomson
Keyword(s):  
Psychiatric Comorbidity ◽  
Death Certificate ◽  
Age Group ◽  
Death Certificates ◽  
Unexpected Death ◽  
Psychiatric Comorbidities ◽  
National Patient Registry ◽  
Hospital Discharge Diagnosis ◽  
Death Registry ◽  
National Patient

Objective:To identify all cases of sudden unexpected death in epilepsy (SUDEP) among people in Sweden during 1 year and to determine the SUDEP incidence in relation to age, sex, and psychiatric comorbidity.Methods:We included all individuals with a hospital-based ambulatory care or hospital discharge diagnosis of epilepsy in the Swedish National Patient Registry during 1998–2005 who were alive on January 1, 2008. Deaths during 2008 were identified by linkage to the National Cause of Death Registry. Death certificates, medical charts, and police and autopsy reports were extensively reviewed to identify SUDEP cases.Results:Of 57,775 epilepsy patients alive on January 1, 2008, 1,890 died (3.3%) during 2008. Of these, 99 met the Annegers SUDEP criteria (49 definite, 19 probable, and 31 possible). SUDEP accounted for 5.2% of all deaths and 36% of deaths in the 0–15 years age group. The incidence of definite/probable SUDEP was 1.20/1,000 person-years, and higher in men (1.41) than in women (0.96). All SUDEP cases <16 years were in boys. SUDEP incidence at ages <16, 16–50, and >50 years was 1.11, 1.13, and 1.29, respectively, per 1,000 person-years. The incidence was 5-fold increased among female patients with psychiatric comorbidities compared to those without. Epilepsy was mentioned on the death certificate in only 62 of the 99 (63%) SUDEP cases.Conclusions:Methods relying on death certificates underestimate SUDEP incidence. SUDEP risk has been underestimated especially in boys and in older people regardless of sex. Patients with psychiatric comorbidities, women in particular, are at increased SUDEP risk.

scholarly journals Factors Associated with Psychiatric Comorbidity in Depression Patients in Primary Health Care in Chile

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Alfredo Cancino ◽  
Marcelo Leiva-Bianchi ◽  
Carlos Serrano ◽  
Soledad Ballesteros-Teuber ◽  
Cristian Cáceres ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Life Events ◽  
Psychiatric Comorbidity ◽  
Stressful Life Events ◽  
Clinical Severity ◽  
Stressful Life ◽  
Psychiatric Comorbidities ◽  
Factors Associated ◽  
Primary Health

Objective. To identify the clinical and psychosocial factors associated with psychiatric comorbidity in patients consulting for depression in Primary Health Care (PHC) in Chile. Methods. 394 patients with a diagnosis of major depression being treated in a Chilean PHC were evaluated using a sociodemographic and clinical interview, the mini-international neuropsychiatric interview (MINI), a childhood trauma events (CTEs) screening, the intimate partner violence (IPV) scale, the Life Experiences Survey (LES), and the Hamilton Depression Rating Scale (HDRS). Results. Positive correlations were established between higher number of psychiatric comorbidities and severity of depressive symptoms (r = 0.358), frequency of CTEs (r = 0.228), frequency of IPV events (r = 0.218), frequency of recent stressful life events (r = 0.188), number of previous depressive episodes (r = 0.340), and duration of these (r = 0.120). Inverse correlations were determined with age at the time of the first consultation (r = -0.168), age of onset of depression (r = -0.320), and number of medical comorbidities (r = -0.140). Of all associated factors, early age of the first depressive episode, CTEs antecedents, and recent stressful life events explain 13.6% of total variability in psychiatric comorbidities. Conclusions. A higher prevalence of psychiatric comorbidity among subjects seeking help for depression in Chilean PHCs is associated with early onset of depression, clinical severity, chronicity, and interpersonal adversity experienced since childhood.

scholarly journals Secular trends in the incidence and prevalence of gout in Denmark from 1995 to 2015: a nationwide register-based study

Rheumatology ◽  
2018 ◽  
Vol 58 (5) ◽  
pp. 836-839 ◽  
Author(s):  
Kristian Zobbe ◽  
Daniel Prieto-Alhambra ◽  
René Cordtz ◽  
Pil Højgaard ◽  
Jens Skøt Hindrup ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Incidence Rates ◽  
Secular Trends ◽  
Annual Incidence Rate ◽  
Danish Population ◽  
Age And Gender ◽  
National Patient Registry ◽  
National Patient ◽  
And Gender ◽  
Gender Specific

Abstract Objective To investigate temporal trends in the incidence and prevalence of gout in the adult Danish population. Methods Using the nationwide Danish National Patient Registry, we calculated the number of incident gout patients (per 100 000 person-years) within each 1 year period from 1995 to 2015 and the prevalence of gout in 2000 and 2015. Further, we calculated age- and gender-specific incidence rates of gout from 1995 to 2015. Results We identified a total of 45 685 incident gout patients (72.9% males) with a mean age of 65 years (s.d. 16) at diagnosis. In both genders, an increase in age-standardized incidence rates was observed from 32.3/100 000 (95% CI 30.7, 33.9) in 1995 to 57.5/100 000 (95% CI 55.6, 59.5) in 2015 (P < 0.001). Similar trends were observed for 8950 cases diagnosed in rheumatology departments. We likewise observed an increase in the prevalence of gout from 0.29% (95% CI 0.29, 0.30) in 2000 to 0.68% (95% CI 0.68, 0.69) in 2015. Conclusions The annual incidence rate of gout increased by almost 80% in Denmark between 1995 and 2015. The prevalence increased by nearly 130% between 2000 and 2015. Reasons for this are unknown but may include an increase in risk factors (e.g. obesity, diabetes mellitus), longer life expectancy and increased awareness of the disease among patients and/or health professionals.

scholarly journals Does a mandatory non-medical switch from originator to biosimilar infliximab lead to increased use of outpatient healthcare resources? A register-based study in patients with inflammatory arthritis

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000710 ◽  
Author(s):  
Bente Glintborg ◽  
Jan Sørensen ◽  
Merete Lund Hetland
Keyword(s):  
Inflammatory Arthritis ◽  
Interrupted Time Series ◽  
Observational Cohort Study ◽  
Interrupted Time Series Analysis ◽  
Healthcare Resources ◽  
National Patient Registry ◽  
National Patient ◽  
Observational Cohort ◽  
Hospital Resources ◽  
Number Of Visits

ObjectivesNational Danish guidelines in May 2015 dictated a mandatory switch from originator infliximab (INX) to biosimilar CT-P13 in patients with inflammatory rheumatic disease. We investigated if this non-medical switch changed use of outpatient hospital resources.MethodsObservational cohort study. Switchers were identified in DANBIO. Rheumatic outpatient contacts, visits and services were identified in the National Patient Registry. The 6-month rate for (1) number of visits (or services) and (2) days with ≥1 visit (or service) were compared before/after switching (paired t-tests). Visits per week per patient before/after the switch date were analysed with graphical interrupted time-series analysis.ResultsIn 769 switchers (372 males, median age 54 years (IQR 44–66)), 1484 outpatient contacts, 6718 visits and 9243 days with services (693 on switch date) were identified. Mean visit rate was 3.89 before and 3.95 after switch (p=0.35). Total number of services was 19 752 (2019 on switch date). Mean rates before/after switch for 16 service categories were small and differences close to zero. Visits per week per patient appeared similar before/after switch with peaks every ≈8 weeks (standard INX infusion interval).ConclusionChanges were marginal with no clinically relevant increase in use of outpatient health care resources 6 months after compared with 6 months before mandatory switch from originator to biosimilar infliximab.

scholarly journals Positive predictive value of ICD-10 diagnosis codes for brain abscess in the Danish National Patient Registry

2018 ◽  
Vol Volume 10 ◽  
pp. 1503-1508 ◽  
Author(s):  
Jacob Bodilsen ◽  
Michael Dalager-Pedersen ◽  
Nicolai Kjærgaard ◽  
Diederik van de Beek ◽  
Matthijs C Brouwer ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Brain Abscess ◽  
Predictive Value ◽  
Patient Registry ◽  
National Patient Registry ◽  
Diagnosis Codes ◽  
Danish National Patient Registry ◽  
National Patient ◽  
Icd 10

scholarly journals Validity and underrecording of diagnosis of COPD in the Danish National Patient Registry

2011 ◽  
Vol 105 (7) ◽  
pp. 1063-1068 ◽  
Author(s):  
Reimar W. Thomsen ◽  
Peter Lange ◽  
Birthe Hellquist ◽  
Ejvind Frausing ◽  
Paul D. Bartels ◽  
...  
Keyword(s):  
Patient Registry ◽  
National Patient Registry ◽  
Danish National Patient Registry ◽  
National Patient

scholarly journals MOLECULAR AUTOPSY: EVALUATION OF SUDDEN UNEXPECTED DEATH CASES IN TERMS OF “KCNQ1” GENETIC VARIATION

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Kenan Kaya ◽  
Mete Korkut Gülmen ◽  
Ayşe Serin ◽  
Necmi Çekin ◽  
Ahmet Hilal
Keyword(s):  
Genetic Variation ◽  
Genetic Analysis ◽  
Cause Of Death ◽  
Conduction System ◽  
Sudden Unexpected Death ◽  
Age Group ◽  
Unexpected Death ◽  
Molecular Autopsy ◽  
Sequence Variations ◽  
Death Cases

Background: Deaths occuring without a known disease and/or a known cause, deaths with non-lethal diseases are interpretated as sudden-unexpected-suspected deaths. Autopsy should always required to evaluate the cause of death. Some of the cases can be termed as negative autopsy since the cause of death can not be determined. This is one of the main interests of the future forensics. Molecular autopsies are one of the main practices of to reduce the negative autopsy ratios. Thus, post-mortem KCNQ1 genetic variation tests are done in sudden unexpected death cases. Material and methods: In this study 0 – 50 years old sudden-unexpected deaths autopsy cases were handled. Samples taken from cases were evaluated and “KCNQ1” genetic variation tests were done in our Department. Results: This study included 47 cases of 42 sudden unexpected death cases (0 – 50 age group) and 5 control group. 15 cases were between 40 – 50 age group and number of cases were increasing with age. 29 of cases (% 69) were male. Evaluation of body-mass index of cases were done and normal weighted cases were the most common with 21 cases (% 50). According to death locations; 17 cases had died (% 45,9) at home. Death location records of 5 cases couldn’t be found. Pathological examinations of all cases were done. We had identified fibrosis and fatty change appearances in SA node of 9 cases (% 21,4) and AV node of 13 cases (% 30,9) especially in conduction tissue examinations. As the result of KCNQ1 genetic analysis of cases, we identified sequence variations in 1638th nucleotid of exon 13 and 1986th nucleotid of exon 16. Conclusion: Cases with conduction system pathology and sequence variations of KCNQ1 genetic analysis shows that we are in need of these tests among routine practice to reduce negative autopsy ratios. Key words: KCNQ1, molecular autopsy, sudden unexpected death, conduction system, negative autopsy.

scholarly journals Positive predictive value of infective endocarditis in the Danish National Patient Registry: a validation study

2018 ◽  
Vol 146 (15) ◽  
pp. 1965-1967 ◽  
Author(s):  
Lauge Østergaard ◽  
Kasper Adelborg ◽  
Jens Sundbøll ◽  
Lars Pedersen ◽  
Emil Loldrup Fosbøl ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Medical Records ◽  
Electronic Device ◽  
Patient Registry ◽  
Cardiac Implantable Electronic Device ◽  
National Patient Registry ◽  
Danish National Patient Registry ◽  
National Patient

AbstractThe positive predictive value of an infective endocarditis diagnosis is approximately 80% in the Danish National Patient Registry. However, since infective endocarditis is a heterogeneous disease implying long-term intravenous treatment, we hypothesiszed that the positive predictive value varies by length of hospital stay. A total of 100 patients with first-time infective endocarditis in the Danish National Patient Registry were identified from January 2010 – December 2012 at the University hospital of Aarhus and regional hospitals of Herning and Randers. Medical records were reviewed. We calculated the positive predictive value according to admission length, and separately for patients with a cardiac implantable electronic device and a prosthetic heart valve using the Wilson score method. Among the 92 medical records available for review, the majority of the patients had admission length ⩾2 weeks. The positive predictive value increased with length of admission. In patients with admission length <2 weeks the positive predictive value was 65% while it was 90% for admission length ⩾2 weeks. The positive predictive value was 81% for patients with a cardiac implantable electronic device and 87% for patients with a prosthetic valve. The positive predictive value of the infective endocarditis diagnosis in the Danish National Patient Registry is high for patients with admission length ⩾2 weeks. Using this algorithm, the Danish National Patient Registry provides a valid source for identifying infective endocarditis for research.

scholarly journals Positive predictive value of acute and chronic pancreatitis diagnoses in the Danish National Patient Registry: A validation study

2018 ◽  
Vol 48 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Jakob Kirkegård ◽  
Marie R. Mortensen ◽  
Ida R. Johannsen ◽  
Frank V. Mortensen ◽  
Deirdre Cronin-Fenton
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Medical Records ◽  
Patient Registry ◽  
National Patient Registry ◽  
Danish National Patient Registry ◽  
National Patient ◽  
Acute And Chronic Pancreatitis

Aims: To examine the validity of the diagnoses of acute and chronic pancreatitis registered in the Danish National Patient Registry. Methods: We identified all patients in the Danish National Patient Registry admitted to two Danish hospitals with acute or chronic pancreatitis from 1996 to 2013. From this population, we randomly sampled 100 patients with acute pancreatitis and 100 patients with chronic pancreatitis. For each cohort, we computed the positive predictive values and associated 95% confidence intervals (CIs) for the discharge diagnosis of acute or chronic pancreatitis using medical records as the gold standard. Results: We identified 2617 patients with acute pancreatitis and 1284 patients with chronic pancreatitis discharged from either of the two hospitals during the study period. Of these, 776 (19.9%) had a diagnosis of both acute and chronic pancreatitis and are thus present in both cohorts. From the 200 sampled patients, a total of 138 (69.0%) medical records were available for review. The positive predictive value for a diagnosis of acute pancreatitis in the Danish National Patient Registry was 97.3% (95% CI 90.5–99.2%) and for chronic pancreatitis 83.1% (95% CI 72.2–90.3%). Conclusions: The validity of diagnoses of acute and chronic pancreatitis registered in the Danish National Patient Registry since 1996 is generally high.

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