Characteristics of motor vehicle crashes and fatality risk among drivers with epilepsy

IF 6.6 1区医学 Q1 CLINICAL NEUROLOGY Epilepsia Pub Date : 2024-08-21 DOI:10.1111/epi.18097

Yu Sun, Meng-Yun Ku, Chih-Ching Liu, Li-Nien Chien

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Abstract

Objective

Among motor vehicle crashes (MVCs), little is known about whether the characteristics and collision features involving drivers with epilepsy differ from those involving drivers without any history of epilepsy. We assessed MVC features and the effect of epilepsy diagnosis on the risk of severe crash-related injuries among drivers.

Methods

A total of 33 174 MVC events among people with epilepsy (PWE) and 663 480 MVC events of age- and sex-matched non-PWE (1:20) were selected. Crash-related features that involved drivers with and without epilepsy were compared, including driver eligibility, medical history of comorbidities and medications, road and environmental conditions, and accident causes. Cox and logistic regression analyses were used to examine the risks of fatality and severe injury among drivers with and without epilepsy.

Results

PWE involved in MVCs were more likely to have lower socioeconomic status, comorbidities, scooter drivers without a qualified driver's license, driving under the influence of alcohol, and be involved in single-vehicle accidents than non-PWE. Drivers with epilepsy also had a higher risk of fatality within 30 days of MVC, with an adjusted hazard ratio (aHR) of 1.37 (95% confidence interval [CI], 1.20–1.57) and a higher risk of hospital admission within 3 days after MVC (aHR, 1.33; 95% CI, 1.29–1.38) compared to that of non-PWE.

Significance

The characteristics of MVCs of drivers with epilepsy were distinct from those of non-affected drivers. And higher fatality and injury rates were observed among drivers with epilepsy, which should be considered in further policymaking regarding safe driving of PWE.

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机动车碰撞事故的特点和癫痫司机的死亡风险。

目的：在机动车碰撞事故（MVCs）中，人们对患有癫痫的驾驶员与没有癫痫病史的驾驶员在特征和碰撞特征上是否存在差异知之甚少。我们评估了机动车碰撞的特征以及癫痫诊断对驾驶员在碰撞中严重受伤风险的影响：方法：我们选取了33 174起癫痫患者（PWE）与663 480起年龄和性别匹配的非癫痫患者（1:20）的机动车碰撞事故。比较了有癫痫和无癫痫的驾驶员的碰撞相关特征，包括驾驶员资格、合并症和药物的病史、道路和环境条件以及事故原因。采用Cox和Logistic回归分析来研究有癫痫和无癫痫司机的死亡和重伤风险：结果：与非癫痫患者相比，卷入机动车碰撞事故的癫痫患者更有可能社会经济地位较低、患有合并症、没有合格驾驶执照、在酒精影响下驾驶滑板车以及卷入单车事故。与非 PWE 相比，患有癫痫的驾驶员在发生交通事故后 30 天内死亡的风险也更高，调整后的危险比（aHR）为 1.37（95% 置信区间 [CI]，1.20-1.57），在发生交通事故后 3 天内入院的风险也更高（aHR，1.33；95% CI，1.29-1.38）：重要意义：患有癫痫的驾驶员与未患癫痫的驾驶员在发生车祸时的特征截然不同。癫痫症驾驶者的死亡率和受伤率都较高，在制定有关残疾人安全驾驶的进一步政策时应考虑到这一点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epilepsia 医学-临床神经学

CiteScore

10.90

自引率

10.70%

发文量

319

审稿时长

2-4 weeks

期刊介绍： Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.