High Risk of Gastrointestinal Hemorrhage in Patients With Epilepsy: A Nationwide Cohort Study |
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Authors: | Chun-Chieh Yeh Hwang-Huei Wang Yi-Chun Chou Chaur-Jong Hu Wan-Hsin Chou Ta-Liang Chen Chien-Chang Liao |
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Institution: | 1. Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan;2. School of Medicine, China Medical University, Taichung, Taiwan;3. Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan;4. Department of Surgery, China Medical University Hospital, Taichung, Taiwan;5. Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan;6. Department of Neurology, School of Medicine, Taipei Medical University, Taipei, Taiwan;7. School of Medicine, Taipei Medical University, Taipei, Taiwan;8. Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan;9. Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan |
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Abstract: | ObjectiveTo examine the association between epilepsy and gastrointestinal hemorrhage.Patients and MethodsWe 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.ResultsCompared 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).ConclusionEpilepsy 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. |
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Keywords: | COPD"} {"#name":"keyword" "$":{"id":"kwrd0015"} "$$":[{"#name":"text" "_":"chronic obstructive pulmonary disease HR"} {"#name":"keyword" "$":{"id":"kwrd0025"} "$$":[{"#name":"text" "_":"hazard ratio NSAID"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"nonsteroidal anti-inflammatory drug TBI"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"traumatic brain injury |
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