Co-morbidities in a Hong Kong Cohort

People with epilepsy have a higher prevalence of psychiatric and medical comorbid conditions than the general population. Now a recent review of patients with newly diagnosed and treated epilepsy admitted to Hong Kong hospitals has revealed that even patients without a long history of epilepsy have increased morbidity and mortality.

Chen and colleagues took advantage of the fact that more than 90% of the Hong Kong population receives healthcare from a single public provider with an electronic database. They studied a population of 7461 patients (55% male) newly diagnosed with epilepsy who commenced antiepileptic drug treatment during hospitalization in a 5-year period (September 16, 2005 to September 15, 2010).

At baseline, more than half of the patients had 1 or more psychiatric (16.4%) or physical comorbidities (53%) or both (11%). The standardized hospital rate was 6.76 compared with the general population. Cerebrovascular disease was the most frequently recorded physical comorbidity, occurring in 78% of patients with a physical comorbidity. Epilepsy patients also had an increased risk of developing ischemic heart disease, expressed as a standardized incidence ratio (SIR) of 4.18. The SIR for cancer was elevated even after excluding central nervous system cancers (1.48). A striking 2166 (29%) patients died during the 5-year study. The standardized mortality ratio was highest in those with both psychiatric and physical comorbidities (6.47).