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High risk of gastrointestinal hemorrhage in patients with epilepsy: a nationwide cohort study.
Mayo Clin Proc 2013; 88(10):1091-8MC

Abstract

OBJECTIVE

To examine the association between epilepsy and gastrointestinal hemorrhage.

PATIENTS AND METHODS

We conducted a nationwide retrospective cohort study by using data from Taiwan's National Health Insurance Research Database. Patients 20 years and older newly diagnosed as having epilepsy and nonepileptic adults were identified between January 1, 2000, and December 31, 2003, and were observed through December 31, 2008. Cox proportional hazards models were performed to calculate adjusted hazard ratios (HRs) and 95% CIs of gastrointestinal hemorrhage associated with epilepsy.

RESULTS

Compared with the nonepileptic group (n=449,541), epileptic patients (n=1412) had a higher incidence of gastrointestinal hemorrhage (13.4 vs 2.9 per 1000 person-years), with an HR of 2.97 (95% CI, 2.49-3.53). The HRs of gastrointestinal hemorrhage for patients with generalized epilepsy, inpatient care, emergency care, and frequent outpatient visits for epilepsy were 3.50 (95% CI, 2.59-4.72), 3.96 (95% CI, 2.85-5.50), 4.35 (95% CI, 3.15-6.01), and 4.96 (95% CI, 3.97-6.21), respectively. Risks were significantly higher in epileptic patients with mental disorders (HR, 3.20; 95% CI, 2.55-4.01), aged 70 years and older (HR, 4.08; 95% CI, 2.89-5.77), and in the first year after epilepsy (HR, 4.81; 95%, CI, 3.14-7.34).

CONCLUSION

Epilepsy is an independent determinant for gastrointestinal hemorrhage in a chronological and severity-dependent pattern. We urge the development of an adequate surveillance policy and strategy for the early prevention of gastrointestinal hemorrhage in epileptic patients.

Authors+Show Affiliations

Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Department of Surgery, China Medical University Hospital, Taichung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24012412

Citation

Yeh, Chun-Chieh, et al. "High Risk of Gastrointestinal Hemorrhage in Patients With Epilepsy: a Nationwide Cohort Study." Mayo Clinic Proceedings, vol. 88, no. 10, 2013, pp. 1091-8.
Yeh CC, Wang HH, Chou YC, et al. High risk of gastrointestinal hemorrhage in patients with epilepsy: a nationwide cohort study. Mayo Clin Proc. 2013;88(10):1091-8.
Yeh, C. C., Wang, H. H., Chou, Y. C., Hu, C. J., Chou, W. H., Chen, T. L., & Liao, C. C. (2013). High risk of gastrointestinal hemorrhage in patients with epilepsy: a nationwide cohort study. Mayo Clinic Proceedings, 88(10), pp. 1091-8. doi:10.1016/j.mayocp.2013.06.024.
Yeh CC, et al. High Risk of Gastrointestinal Hemorrhage in Patients With Epilepsy: a Nationwide Cohort Study. Mayo Clin Proc. 2013;88(10):1091-8. PubMed PMID: 24012412.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High risk of gastrointestinal hemorrhage in patients with epilepsy: a nationwide cohort study. AU - Yeh,Chun-Chieh, AU - Wang,Hwang-Huei, AU - Chou,Yi-Chun, AU - Hu,Chaur-Jong, AU - Chou,Wan-Hsin, AU - Chen,Ta-Liang, AU - Liao,Chien-Chang, Y1 - 2013/09/05/ PY - 2013/04/03/received PY - 2013/05/21/revised PY - 2013/06/13/accepted PY - 2013/9/10/entrez PY - 2013/9/10/pubmed PY - 2013/12/16/medline KW - COPD KW - HR KW - ICD-9-CM KW - International Classification of Diseases, Ninth Revision, Clinical Modification KW - NSAID KW - TBI KW - chronic obstructive pulmonary disease KW - hazard ratio KW - nonsteroidal anti-inflammatory drug KW - traumatic brain injury SP - 1091 EP - 8 JF - Mayo Clinic proceedings JO - Mayo Clin. Proc. VL - 88 IS - 10 N2 - OBJECTIVE: To examine the association between epilepsy and gastrointestinal hemorrhage. PATIENTS AND METHODS: We conducted a nationwide retrospective cohort study by using data from Taiwan's National Health Insurance Research Database. Patients 20 years and older newly diagnosed as having epilepsy and nonepileptic adults were identified between January 1, 2000, and December 31, 2003, and were observed through December 31, 2008. Cox proportional hazards models were performed to calculate adjusted hazard ratios (HRs) and 95% CIs of gastrointestinal hemorrhage associated with epilepsy. RESULTS: Compared with the nonepileptic group (n=449,541), epileptic patients (n=1412) had a higher incidence of gastrointestinal hemorrhage (13.4 vs 2.9 per 1000 person-years), with an HR of 2.97 (95% CI, 2.49-3.53). The HRs of gastrointestinal hemorrhage for patients with generalized epilepsy, inpatient care, emergency care, and frequent outpatient visits for epilepsy were 3.50 (95% CI, 2.59-4.72), 3.96 (95% CI, 2.85-5.50), 4.35 (95% CI, 3.15-6.01), and 4.96 (95% CI, 3.97-6.21), respectively. Risks were significantly higher in epileptic patients with mental disorders (HR, 3.20; 95% CI, 2.55-4.01), aged 70 years and older (HR, 4.08; 95% CI, 2.89-5.77), and in the first year after epilepsy (HR, 4.81; 95%, CI, 3.14-7.34). CONCLUSION: Epilepsy is an independent determinant for gastrointestinal hemorrhage in a chronological and severity-dependent pattern. We urge the development of an adequate surveillance policy and strategy for the early prevention of gastrointestinal hemorrhage in epileptic patients. SN - 1942-5546 UR - https://www.unboundmedicine.com/medline/citation/24012412/High_risk_of_gastrointestinal_hemorrhage_in_patients_with_epilepsy:_a_nationwide_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0025-6196(13)00610-1 DB - PRIME DP - Unbound Medicine ER -