Observational studyEpilepsia2018
Long-term surveillance of SUDEP in drug-resistant epilepsy patients treated with VNS therapy.
Observational study in Epilepsia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
58 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- [Incidence of sudden death in epilepsy (SUDEP): update and limitations].Der Nervenarzt · 2024Pooled it
- Drug-resistant epilepsy and mortality-Why and when do neuromodulation and epilepsy surgery reduce overall mortality.Epilepsia · 2022Pooled it
- Vagus nerve stimulation for treatment of drug-resistant epilepsy: a systematic review and meta-analysis.Neurosurgical review · 2022Pooled it
- Treatments for the prevention of Sudden Unexpected Death in Epilepsy (SUDEP).The Cochrane database of systematic reviews · 2020Pooled it
- Chronic vagus nerve stimulation is associated with multi-year improvement in intrinsic heart rate recovery and left ventricular ejection fraction in ANTHEM-HF.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021Trial
- A guide to neuromodulation in drug-resistant epilepsy.Epileptic disorders : international epilepsy journal with videotape · 2026Review
- Non-invasive Vagal Nerve Stimulation as a Potential Treatment for Repetitive Blast Trauma.bioRxiv : the preprint server for biology · 2026Article
- A deep representation learning model to predict response to vagus nerve stimulation.Nature communications · 2026Article
- Current perspectives in sudden unexpected death in epilepsy (SUDEP): epidemiology, research approaches and pathways to prevention.Neurological research and practice · 2026Review
- Best Practices in Clinical Epilepsy Symposium | Mortality in Epilepsy: Challenges and Interventions.Epilepsy currents · 2026Article
- Pathophysiological frameworks and emerging preventative strategies in SUDEP.Frontiers in neurology · 2026Review
- Driving after vagus nerve stimulation therapy: Is it possible?Epilepsia open · 2025Observational
- Sudden Unexpected Death in Epilepsy: A Narrative Review of Mechanism, Risks, and Prevention.Journal of clinical medicine · 2025Review
- The physiology, anatomy and stimulation of the vagus nerve in epilepsy.The Journal of physiology · 2025Review
- Invasive Neurostimulation for the Treatment of Epilepsy.Seminars in neurology · 2025Review
- One-year seizure freedom and quality of life in patients with drug-resistant epilepsy receiving adjunctive vagus nerve stimulation in Japan.Epilepsia open · 2024Observational
- Vagus Nerve Stimulation Therapy in Epilepsy: An Overview of Technical and Surgical Method, Patient Selection, and Treatment Outcomes.Brain sciences · 2024Review
- Complications and Mortality Rate of Vagus Nerve Stimulation for Drug-Resistant Epilepsy.Cureus · 2024Article
- Research progress on the electrophysiological indicators to predict the efficacy of vagus nerve stimulation for drug-refractory epilepsy.Acta epileptologica · 2024Review
- Vagus Nerve Stimulation Therapy for Drug-Resistant Epilepsy in Children-A Literature Review.Journal of clinical medicine · 2024Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveLimited data are available regarding the evolution over time of the rate of sudden unexpected death in epilepsy patients (SUDEP) in drug-resistant epilepsy. The objective is to analyze a database of 40 443 patients with epilepsy implanted with vagus nerve stimulation (VNS) therapy in the United States (from 1988 to 2012) and assess whether SUDEP rates decrease during the postimplantation follow-up period.
methodsPatient vital status was ascertained using the Centers for Disease Control and Prevention's National Death Index (NDI). An expert panel adjudicated classification of cause of deaths as SUDEP based on NDI data and available narrative descriptions of deaths. We tested the hypothesis that SUDEP rates decrease with time using the Mann-Kendall nonparametric trend test and by comparing SUDEP rates of the first 2 years of follow-up (years 1-2) to longer follow-up (years 3-10).
resultsOur cohort included 277 661 person-years of follow-up and 3689 deaths, including 632 SUDEP. Primary analysis demonstrated a significant decrease in age-adjusted SUDEP rate during follow-up (S = -27 P = .008), with rates of 2.47/1000 for years 1-2 and 1.68/1000 for years 3-10 (rate ratio 0.68; 95% confidence interval [CI] 0.53-0.87; P = .002). Sensitivity analyses confirm these findings. SIGNIFICANCE: Our data suggest that SUDEP risk significantly decreases during long-term follow-up of patients with refractory epilepsy receiving VNS Therapy. This finding might reflect several factors, including the natural long-term dynamic of SUDEP rate, attrition, and the impact of VNS Therapy. The role of each of these factors cannot be confirmed due to the limitations of the study.
Indexed as
Identifiers
29336017What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.