Injury Among Children and Young Adults With Epilepsy
- 1 May 2014
- journal article
- Published by American Academy of Pediatrics (AAP) in Pediatrics
- Vol. 133 (5), 827-835
- https://doi.org/10.1542/peds.2013-2554
Abstract
OBJECTIVE: To investigate whether children and young adults with epilepsy are at a greater risk of fracture, thermal injury, or poisoning than those without. METHODS: A cohort study was conducted by using the Clinical Practice Research Datalink (1987–2009), a longitudinal database containing primary care records. A total of 11 934 people with epilepsy and 46 598 without, aged between 1 and 24 years at diagnosis, were followed for a median (interquartile range) of 2.6 (0.8–5.9) years. The risk of fractures (including long bone fractures), thermal injuries, and poisonings (including medicinal and nonmedicinal poisonings) was estimated. RESULTS: Adjusting for age, gender, Strategic Health Authority region, deprivation, and calendar year at study entry (and, for medicinal poisonings, behavior disorder), people with epilepsy had an 18% increase in risk of fracture (hazard ratio [HR] = 1.18; 95% confidence interval [CI], 1.09–1.27), a 23% increase in risk of long bone fracture (HR = 1.23; 95% CI, 1.10–1.38), a 49% increase in risk of thermal injury (HR = 1.49; 95% CI, 1.27–1.75), and more than twice the risk of poisoning (HR = 2.47; 95% CI, 2.15–2.84), which was limited to poisoning from medicinal products (medicinal HR = 2.54; 95% CI, 2.16–2.99; nonmedicinal HR = 0.96; 95% CI, 0.61–1.52). CONCLUSIONS: Children and young adults with epilepsy are at a greater risk of fracture, thermal injury, and poisoning than those without. The greatest risk is from medicinal poisonings. Doctors and other health care professionals should provide injury and poison prevention advice at diagnosis and epilepsy reviews.Keywords
This publication has 40 references indexed in Scilit:
- Home safety education and provision of safety equipment for injury preventionCochrane Database of Systematic Reviews, 2012
- Decreasing incidence and changing pattern of childhood fractures: A population-based studyJournal of Bone and Mineral Research, 2010
- Epidemiology of fractures in children and adolescentsActa Orthopaedica, 2010
- Validation and validity of diagnoses in the General Practice Research Database: a systematic reviewBritish Journal of Clinical Pharmacology, 2009
- Stages of development and injury: An epidemiological survey of young children presenting to an emergency departmentBMC Public Health, 2008
- Epilepsy, osteoporosis and fracture risk - a meta-analysisActa Neurologica Scandinavica, 2005
- Epileptic Seizures and Epilepsy: Definitions Proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE)Epilepsia, 2005
- Measure for measureThe quest for valid indicators of non-fatal injury incidencePublic Health, 2002
- The use of a large pharmacoepidemiological database to study exposure to oral corticosteroids and risk of fractures: validation of study population and resultsPharmacoepidemiology and Drug Safety, 2000
- Repetition of accidents in young children.Journal of Epidemiology and Community Health, 1986