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Stratifying sudden death risk in adults with drug‐resistant focal epilepsy: The SUDEP‐CARE score
BACKGROUND AND PURPOSE: A clinical risk score for sudden unexpected death in epilepsy (SUDEP) in patients with drug‐resistant focal epilepsy could help improve prevention. METHODS: A case–control study was conducted including (i) definite or probable SUDEP cases collected by the French National Sent...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087018/ https://www.ncbi.nlm.nih.gov/pubmed/36094672 http://dx.doi.org/10.1111/ene.15566 |
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author | Serrand, Chris Rheims, Sylvain Faucanié, Marie Crespel, Arielle Dinkelacker, Vera Szurhaj, William Biraben, Arnaud Bartolomei, Fabrice de Grissac, Nathalie Landré, Elizabeth Denuelle, Marie Vercueil, Laurent Marchal, Cécile Maillard, Louis Derambure, Philippe Dupont, Sophie Navarro, Vincent Mura, Thibault Jaussent, Audrey Macioce, Valérie Ryvlin, Philippe Picot, Marie‐Christine |
author_facet | Serrand, Chris Rheims, Sylvain Faucanié, Marie Crespel, Arielle Dinkelacker, Vera Szurhaj, William Biraben, Arnaud Bartolomei, Fabrice de Grissac, Nathalie Landré, Elizabeth Denuelle, Marie Vercueil, Laurent Marchal, Cécile Maillard, Louis Derambure, Philippe Dupont, Sophie Navarro, Vincent Mura, Thibault Jaussent, Audrey Macioce, Valérie Ryvlin, Philippe Picot, Marie‐Christine |
author_sort | Serrand, Chris |
collection | PubMed |
description | BACKGROUND AND PURPOSE: A clinical risk score for sudden unexpected death in epilepsy (SUDEP) in patients with drug‐resistant focal epilepsy could help improve prevention. METHODS: A case–control study was conducted including (i) definite or probable SUDEP cases collected by the French National Sentinel Mortality Epilepsy Network and (ii) control patients from the French national research database of epilepsy monitoring units. Patients with drug‐resistant focal epilepsy were eligible. Multiple logistic regressions were performed. After sensitivity analysis and internal validation, a simplified risk score was developed from the selected variables. RESULTS: Sixty‐two SUDEP cases and 620 controls were included. Of 21 potential predictors explored, seven were ultimately selected, including generalized seizure frequency (>1/month vs. <1/year: adjusted odds ratio [AOR] 2.6, 95% confidence interval [CI] 1.25–5.41), nocturnal or sleep‐related seizures (AOR 4.49, 95% CI 2.68–7.53), current or past depression (AOR 2.0, 95% CI 1.19–3.34) or the ability to alert someone of an oncoming seizure (AOR 0.57, 95% CI 0.33–0.98). After internal validation, a clinically usable score ranging from −1 to 8 was developed, with high discrimination capabilities (area under the receiver operating curve 0.85, 95% CI 0.80–0.90). The threshold of 3 has good sensitivity (82.3%, 95% CI 72.7–91.8), whilst keeping a good specificity (82.7%, 95% CI 79.8–85.7). CONCLUSIONS: These results outline the importance of generalized and nocturnal seizures on the occurrence of SUDEP, and show a protective role in the ability to alert someone of an oncoming seizure. The SUDEP‐CARE score is promising and will need external validation. Further work, including paraclinical explorations, could improve this risk score. |
format | Online Article Text |
id | pubmed-10087018 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-100870182023-04-12 Stratifying sudden death risk in adults with drug‐resistant focal epilepsy: The SUDEP‐CARE score Serrand, Chris Rheims, Sylvain Faucanié, Marie Crespel, Arielle Dinkelacker, Vera Szurhaj, William Biraben, Arnaud Bartolomei, Fabrice de Grissac, Nathalie Landré, Elizabeth Denuelle, Marie Vercueil, Laurent Marchal, Cécile Maillard, Louis Derambure, Philippe Dupont, Sophie Navarro, Vincent Mura, Thibault Jaussent, Audrey Macioce, Valérie Ryvlin, Philippe Picot, Marie‐Christine Eur J Neurol Epilepsy BACKGROUND AND PURPOSE: A clinical risk score for sudden unexpected death in epilepsy (SUDEP) in patients with drug‐resistant focal epilepsy could help improve prevention. METHODS: A case–control study was conducted including (i) definite or probable SUDEP cases collected by the French National Sentinel Mortality Epilepsy Network and (ii) control patients from the French national research database of epilepsy monitoring units. Patients with drug‐resistant focal epilepsy were eligible. Multiple logistic regressions were performed. After sensitivity analysis and internal validation, a simplified risk score was developed from the selected variables. RESULTS: Sixty‐two SUDEP cases and 620 controls were included. Of 21 potential predictors explored, seven were ultimately selected, including generalized seizure frequency (>1/month vs. <1/year: adjusted odds ratio [AOR] 2.6, 95% confidence interval [CI] 1.25–5.41), nocturnal or sleep‐related seizures (AOR 4.49, 95% CI 2.68–7.53), current or past depression (AOR 2.0, 95% CI 1.19–3.34) or the ability to alert someone of an oncoming seizure (AOR 0.57, 95% CI 0.33–0.98). After internal validation, a clinically usable score ranging from −1 to 8 was developed, with high discrimination capabilities (area under the receiver operating curve 0.85, 95% CI 0.80–0.90). The threshold of 3 has good sensitivity (82.3%, 95% CI 72.7–91.8), whilst keeping a good specificity (82.7%, 95% CI 79.8–85.7). CONCLUSIONS: These results outline the importance of generalized and nocturnal seizures on the occurrence of SUDEP, and show a protective role in the ability to alert someone of an oncoming seizure. The SUDEP‐CARE score is promising and will need external validation. Further work, including paraclinical explorations, could improve this risk score. John Wiley and Sons Inc. 2022-09-27 2023-01 /pmc/articles/PMC10087018/ /pubmed/36094672 http://dx.doi.org/10.1111/ene.15566 Text en © 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Epilepsy Serrand, Chris Rheims, Sylvain Faucanié, Marie Crespel, Arielle Dinkelacker, Vera Szurhaj, William Biraben, Arnaud Bartolomei, Fabrice de Grissac, Nathalie Landré, Elizabeth Denuelle, Marie Vercueil, Laurent Marchal, Cécile Maillard, Louis Derambure, Philippe Dupont, Sophie Navarro, Vincent Mura, Thibault Jaussent, Audrey Macioce, Valérie Ryvlin, Philippe Picot, Marie‐Christine Stratifying sudden death risk in adults with drug‐resistant focal epilepsy: The SUDEP‐CARE score |
title | Stratifying sudden death risk in adults with drug‐resistant focal epilepsy: The SUDEP‐CARE score |
title_full | Stratifying sudden death risk in adults with drug‐resistant focal epilepsy: The SUDEP‐CARE score |
title_fullStr | Stratifying sudden death risk in adults with drug‐resistant focal epilepsy: The SUDEP‐CARE score |
title_full_unstemmed | Stratifying sudden death risk in adults with drug‐resistant focal epilepsy: The SUDEP‐CARE score |
title_short | Stratifying sudden death risk in adults with drug‐resistant focal epilepsy: The SUDEP‐CARE score |
title_sort | stratifying sudden death risk in adults with drug‐resistant focal epilepsy: the sudep‐care score |
topic | Epilepsy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087018/ https://www.ncbi.nlm.nih.gov/pubmed/36094672 http://dx.doi.org/10.1111/ene.15566 |
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