Death in children with febrile seizures: a population-based cohort study.

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  • Institute of General Medical Practice
  • Institute of Epidemiology and Social Medicine
  • National Centre for Register-based Research
  • Centre for Clinical Pharmacology
  • The Department of Paediatrics
BACKGROUND: No studies have had sufficient size to estimate mortality in children with febrile seizures. We studied mortality after febrile seizures in a large population-based cohort of children in Denmark with up to 28 years of follow-up. METHODS: We identified 1 675 643 children born in Denmark between Jan 1, 1977, and Dec 31, 2004, by linking information from nationwide registers for civil service, health, and cause of death. Children were followed up from 3 months of age, until death, emigration, or Aug 31, 2005. We estimated overall and cause-specific mortality after first febrile seizures with survival analyses. Furthermore, we undertook a case-control study nested within the cohort and retrieved information from medical records about febrile seizure and neurological abnormalities for children who died (N=8172) and individually-matched controls (N=40 860). FINDINGS: We identified 8172 children who died, including 232 deaths in 55 215 children with a history of febrile seizures. The mortality rate ratio was 80% higher during the first year (adjusted mortality rate ratio 1.80 [95% CI 1.31-2.40]) and 90% higher during the second year (1.89 [1.27-2.70]) after the first febrile seizure; thereafter it was close to that noted for the general population. 132 of 100 000 children (95% CI 102-163) died within 2 years of a febrile seizure compared with 67 (57-76) deaths per 100 000 children without a history of this disorder. In the nested case-control study, children with simple (15 min or recurrence within 24 h) febrile seizures (1.99 [1.24-3.21]). This finding was partly explained by pre-existing neurological abnormalities and subsequent epilepsy. INTERPRETATION: Long-term mortality is not increased in children with febrile seizures, but there seems to be a small excess mortality during the 2 years after complex febrile seizures. Parents should be reassured that death after febrile seizures is very rare, even in high-risk children.
Original languageEnglish
JournalLancet
Volume372
Issue9637
Pages (from-to)457-63
Number of pages6
ISSN0140-6736
DOIs
Publication statusPublished - 2008

    Research areas

  • Adolescent, Adult, Age Distribution, Apgar Score, Child, Child, Preschool, Cohort Studies, Denmark, Female, Humans, Incidence, Infant, Male, Medical Records, Population Surveillance, Registries, Seizures, Febrile, Severity of Illness Index

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