Abstract：
BACKGROUND: People with epilepsy are at increased risk of multiple co-morbidities that may influence risk of adverse outcomes including impact on quality of life and premature mortality. These risk factors include potentially modifiable clinical characteristics associated with sudden unexpected death in epilepsy (SUDEP). For services to tackle risk, the clinical complexity of the target epilepsy population needs to be defined. While this has been comprehensively studied in large, economically developed countries little knowledge of these issues exist in small economically developed countries, like Malta (population: 500,000).
METHODS: This was a single centre study focused exclusively on patients attending Gozo General Hospital (GGH) Malta. STROBE guidance for reporting cross sectional studies was used to design and report the study. This was a retrospective review of standard care and SUDEP and seizure risks provided to all adults (over 18 years) with epilepsy attending GGH (2018-2021).
RESULTS: The review identified 68 people and 92% were compliant with their anti-seizure medication. A fifth (21%) had an intellectual disability. Despite only one patient having a psychotic illness, 19% were on antipsychotic medication. Only 18% of patients had a specific epilepsy care plan, 6% nocturnal surveillance and none had received advice on SUDEP.
CONCLUSIONS: Patient outcomes may be improved with increasing rates of personalized epilepsy care plans, appropriate nocturnal surveillance and reducing the prescription of antipsychotic medication as it is associated with greater risk of mortality. Issues such as stigma and shame appear to play a significant role in small communities and their access to care.
METHODS: This was a single centre study focused exclusively on patients attending Gozo General Hospital (GGH) Malta. STROBE guidance for reporting cross sectional studies was used to design and report the study. This was a retrospective review of standard care and SUDEP and seizure risks provided to all adults (over 18 years) with epilepsy attending GGH (2018-2021).
RESULTS: The review identified 68 people and 92% were compliant with their anti-seizure medication. A fifth (21%) had an intellectual disability. Despite only one patient having a psychotic illness, 19% were on antipsychotic medication. Only 18% of patients had a specific epilepsy care plan, 6% nocturnal surveillance and none had received advice on SUDEP.
CONCLUSIONS: Patient outcomes may be improved with increasing rates of personalized epilepsy care plans, appropriate nocturnal surveillance and reducing the prescription of antipsychotic medication as it is associated with greater risk of mortality. Issues such as stigma and shame appear to play a significant role in small communities and their access to care.
摘要：
背景：癫痫患者出现多种合并症的风险增加，这些合并症可能会影响不良后果的风险，包括对生活质量和过早死亡的影响。这些危险因素包括与癫痫猝死（SUDEP）相关的潜在可改变的临床特征。对于应对风险的服务，目标癫痫人群的临床复杂性需要明确.虽然这已经得到了广泛的全面研究，经济发达国家对这些问题知之甚少，在经济发达国家，像马耳他（人口：50万）。
方法：这是一项单中心研究，专门针对在马耳他戈佐综合医院（GGH）就诊的患者。使用STROBE报告横断面研究的指导来设计和报告研究。这是对所有参加GGH（2018-2021）的癫痫患者（18岁以上）的标准护理和SUDEP以及癫痫发作风险的回顾性审查。
结果：审查确定有68人和92%的人符合他们的抗癫痫药物。五分之一（21％）患有智力障碍。尽管只有一个病人有精神病,19%服用抗精神病药物。只有18％的患者有特定的癫痫护理计划，6%的夜间监测，没有人收到SUDEP的建议。
结论：随着个性化癫痫护理计划的增加，患者预后可能会得到改善。适当的夜间监测和减少抗精神病药物的处方，因为它与更高的死亡风险相关。污名和羞耻等问题似乎在小社区及其获得护理的机会中起着重要作用。
方法：这是一项单中心研究，专门针对在马耳他戈佐综合医院（GGH）就诊的患者。使用STROBE报告横断面研究的指导来设计和报告研究。这是对所有参加GGH（2018-2021）的癫痫患者（18岁以上）的标准护理和SUDEP以及癫痫发作风险的回顾性审查。
结果：审查确定有68人和92%的人符合他们的抗癫痫药物。五分之一（21％）患有智力障碍。尽管只有一个病人有精神病,19%服用抗精神病药物。只有18％的患者有特定的癫痫护理计划，6%的夜间监测，没有人收到SUDEP的建议。
结论：随着个性化癫痫护理计划的增加，患者预后可能会得到改善。适当的夜间监测和减少抗精神病药物的处方，因为它与更高的死亡风险相关。污名和羞耻等问题似乎在小社区及其获得护理的机会中起着重要作用。
