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Epilepsy mortality in Wales during COVID-19

Helen Daniels Orcid Logo, Arron Lacey, David Mikadze, Ashley Akbari Orcid Logo, Beata Fonferko-Shadrach, Joe Hollinghurst, Ronan Lyons Orcid Logo, Mark Rees, Inder Sawhney, Robert Powell, Michael Kerr, Owen Pickrell Orcid Logo

Seizure - European Journal of Epilepsy, Volume: 94, Pages: 39 - 42

Swansea University Authors: Helen Daniels Orcid Logo, Arron Lacey, Ashley Akbari Orcid Logo, Beata Fonferko-Shadrach, Joe Hollinghurst, Ronan Lyons Orcid Logo, Mark Rees, Inder Sawhney, Robert Powell, Michael Kerr, Owen Pickrell Orcid Logo

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Abstract

Purpose: The COVID-19 pandemic has increased mortality worldwide and those with chronic conditions may have been disproportionally affected. However, it is unknown whether the pandemic has changed mortality rates for people with epilepsy. We aimed to compare mortality rates in people with epilepsy i...

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Published in: Seizure - European Journal of Epilepsy
ISSN: 1059-1311
Published: Elsevier BV 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa58860
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Abstract: Purpose: The COVID-19 pandemic has increased mortality worldwide and those with chronic conditions may have been disproportionally affected. However, it is unknown whether the pandemic has changed mortality rates for people with epilepsy. We aimed to compare mortality rates in people with epilepsy in Wales during the pandemic with pre-pandemic rates. Methods: We performed a retrospective study using individual-level linked population-scale anonymised electronic health records. We identified deaths in people with epilepsy (DPWE), i.e. those with a diagnosis of epilepsy, and deaths associated with epilepsy (DAE), where epilepsy was recorded as a cause of death on death certificates. We compared death rates in 2020 with average rates in 2015–2019 using Poisson models to calculate death rate ratios. Results: There were 188 DAE and 628 DPWE in Wales in 2020 (death rates: 7.7/100,000/year and 25.7/100,000/year). The average rates for DAE and DPWE from 2015 to 2019 were 5.8/100,000/year and 23.8/100,000/year, respectively. Death rate ratios (2020 compared to 2015–2019) for DAE were 1.34 (95%CI 1.14–1.57, p<0.001) and for DPWE were 1.08 (0.99–1.17, p = 0.09). The death rate ratios for non-COVID deaths (deaths without COVID mentioned on death certificates) for DAE were 1.17 (0.99–1.39, p = 0.06) and for DPWE were 0.96 (0.87–1.05, p = 0.37). Conclusions: The significant increase in DAE in Wales during 2020 could be explained by the direct effect of COVID-19 infection. Non-COVID-19 deaths have not increased significantly but further work is needed to assess the longer-term impact.
Keywords: Data linkage, electronic health records, pandemic, COVID-19
College: Swansea University Medical School
Funders: This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust . JH was supported by Health and Care research Wales [Project: SCF-18-1504 ]. AA, JH and RL were supported by the con-cov grant funded by the Medical Research Council (Grant No. MR/V028367/1 ), ADR Wales programme of work funded by the ADR UK (Grant ES/S007393/1 ) and the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales. This work was supported by staff funded as part of the Brain Repair and Intracranial Neurotherapeutics (BRAIN) Unit and the Wales Gene Park, infrastructure support groups funded by Welsh Government through Health and Care Research Wales. This study makes use of anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. We would like to acknowledge all the data providers who make anonymised data available for research. Approval for the use of data in this study, within the SAIL Databank, was granted by an independent information governance review panel (project 0696).
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