A meta-analysis of key risk factors for sudden unexpected death in epilepsy

Purpose: To examine the risk factors (RFs), associated with Sudden Unexpected Death in Epilepsy (SUDEP), and the quantitative standards required to measure them Methods: The literature on RFs associated with SUDEP was systematically reviewed up to August 2020 in databases, including PubMed, the Cochrane Database and Embase. Revised NewcastleOttawa Scale (NOS) was performed to determine the quality of each study in this meta-analysis (MA), with a score of >= 3, indicating good quality. Any controversies in data extraction and quality assessment were resolved through counsel or adjudication with a third researcher. Results: An initial screening of the literature following the search strategy and manual inclusion yielded a total of 767 studies. After excluding duplicates as well as articles that did not match the topic, 112 studies remained. Twenty-nine studies were finally selected based on the inclusion and exclusion criteria. After a careful review of the full text, nine studies were included in the MA. Conclusion: The five RFs for SUDEP included age at the onset of epilepsy <= 15 years, generalizedtonic-clonic seizure, seizure frequency >= 50 seizures/year, treatment with a combination of multiple antiepileptic drugs, and history of alcohol abuse.