Iraq and Afghanistan War Veterans with Epilepsy Have Much Higher Mortality Risk, Study Finds

Iraq and Afghanistan War Veterans with Epilepsy Have Much Higher Mortality Risk, Study Finds

U.S. war veterans who served in Iraq and Afghanistan, and who also have epilepsy, have a mortality risk twice that of veterans without epilepsy, according to recent research.

The study that details these findings was published Nov. 11 in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report, the agency’s journal for scientific publication of useful public health information and recommendations. The publication is titled “Epilepsy among Iraq and Afghanistan War Veterans — United States, 2002–2015.”

The investigators behind this research discovered that U.S. Iraq and Afghanistan veterans (IAVs) with epilepsy were found to have higher rates of mental and physical co-morbidities. In total, 2,187 war veterans met the criteria for epilepsy, culled from the records of more than 320,000 IAVs in 2010 and 2011.

By the end of 2015, approximately five times more IAVs with epilepsy passed away, in comparison with veterans without epilepsy.

Because epilepsy diagnoses in IAVs also are more commonly accompanied by cardiac disease, stroke, cancer and mental health disorders, the researchers also conducted a second analysis to look for correlations between these conditions and to find out if epilepsy alone was contributing to the high mortality rates.

“Similar to studies of civilian samples, we found that cancer, stroke and cardiac disease were strong predictors of five-year mortality. But, even after controlling for the impact of these co-morbid conditions, we still found a substantial effect for epilepsy,” Mary Jo Pugh, PhD, RN, lead author of the study and professor at the University of Texas Health Science Center, said in a press release. “After controlling for co-morbidities, IAVs with epilepsy were about 2.6 times more likely to die during the follow-up period than similar veterans without epilepsy,” she said.

Pugh said federal databases at the time did not disclose the causes of death of war veterans, which kept the report from making speculations about causes of death, such as suicide, car accidents, heart attacks or even sudden unexplained death in epilepsy (SUDEP).

However, the report clarifies that deaths and co-morbidities were more frequent in IAVs with epilepsy, a group found to be highly more vulnerable than others.

“If you have a patient who comes in and is having seizures, that is often the focus of care because persistent seizures can be life-threatening and have a substantial effect on quality of life,” Pugh said. “But chronic disease management for other conditions also is needed. We need to take a holistic approach in epilepsy care. We need to take care of epilepsy and other conditions that affect patients’ health, quality of life and, ultimately, mortality.”

This is the first time a study examining mortality in IAVs with epilepsy has been published, and it is unique in comparison with studies of epilepsy-related mortality in the U.S.

Pugh added that civilian studies in the U.S. have thus far consisted of small samples in limited areas. However, with the more common use of electronic health records, this type of study in civilian settings is becoming more feasible.

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