Logo image
Improving prediction of sudden unexpected death in epilepsy: From SUDEP-7 to SUDEP-3
Journal article   Peer reviewed

Improving prediction of sudden unexpected death in epilepsy: From SUDEP-7 to SUDEP-3

Roozbeh Tarighati Rasekhi, Kathryn N Devlin, Joely A Mass, Mustafa Donmez, Burcu Asma, Michael R Sperling and Maromi Nei
Epilepsia (Copenhagen), v 62(7), pp 1536-1545
Jul 2021
PMID: 34086290

Abstract

Adolescent Adult Electroencephalography Epilepsy - diagnosis Epilepsy - mortality Epilepsy - surgery Epilepsy, Generalized - mortality Epilepsy, Tonic-Clonic - mortality Female Follow-Up Studies Humans Intellectual Disability - mortality Male Middle Aged Predictive Value of Tests Retrospective Studies Seizures - mortality Sudden Unexpected Death in Epilepsy Survival Analysis Young Adult
Sudden unexpected death in epilepsy (SUDEP) is a significant cause of mortality in epilepsy. The aim of this study is to evaluate the validity of the SUDEP-7 inventory and its components as tools for predicting SUDEP risk, and to develop and validate an improved inventory. The study included 28 patients who underwent video-electroencephalography (EEG) monitoring and later died of SUDEP, and 56 age- and sex-matched control patients with epilepsy. The SUDEP-7 score, its individual components, and an alternative inventory were examined as predictors of SUDEP. SUDEP-7 scores were significantly higher among SUDEP patients compared with controls, both at time of admission (p = 0.024) and most recent follow-up (p = 0.016). SUDEP-7 scores declined only among controls, who demonstrated reduced seizure frequency. Seizure freedom after epilepsy surgery was also associated with survival. Several components of the SUDEP-7 inventory were independently associated with higher risk of SUDEP, including more than three generalized tonic-clonic (GTC) seizures (p = 0.002), one or more GTC seizures (p = 0.001), or one or more seizures of any type within the last year (p = 0.013), and intellectual disability (p = 0.031). In stepwise regression models, SUDEP-7 scores did not enhance the prediction of SUDEP over either GTC seizure frequency or seizure frequency alone. A novel SUDEP-3 inventory comprising GTC seizure frequency, seizure frequency, and intellectual disability (p < 0.001) outperformed the SUDEP-7 inventory (p = 0.010) in predicting SUDEP. Our findings demonstrate the limitations of the SUDEP-7 inventory. We propose a new three-item SUDEP-3 inventory, which predicts SUDEP better than the SUDEP-7.

Metrics

6 Record Views
26 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Clinical Neurology
Logo image