{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T22:11:01Z","timestamp":1783203061189,"version":"3.54.6"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82001375"],"award-info":[{"award-number":["82001375"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81271443"],"award-info":[{"award-number":["81271443"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Epilepsy carries an increased risk of premature mortality. Although seizure freedom may reduce deaths, most population\u2010based evidence originates from high\u2010income countries. Data from low\u2010income settings, such as rural China, remain scarce. We update mortality patterns and evaluate their associations with achieving 1\u2010year seizure freedom among rural populations in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>People with epilepsy living in rural Henan, China, were enrolled between 2010 and 2011 and followed up at three subsequent time points over 10\u2009years. We collected demographic and clinical data, including survival outcomes. Seizure freedom was defined as a 12\u2010month seizure\u2010free interval recorded in any follow\u2010up period. Causes of death were assessed using a structured verbal autopsy questionnaire and adjudicated by a multidisciplinary panel. We estimated mortality rates, standardized mortality ratios (SMRs), and cause\u2010specific distributions, and used regression models to identify mortality predictors and associations with seizure freedom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 610 participants enrolled (57.5% male), 67 had died over 10\u2010year follow\u2010up, yielding an all\u2010cause mortality rate of 13.5\/1000 person\u2010years (95% confidence interval [CI] =\u200910.5\u201317.2) and an age\u2010 and sex\u2010adjusted SMR of 2.4 (95% CI\u2009=\u20092.3\u20132.5). Epilepsy\u2010related deaths accounted for 48% of deaths, with sudden unexpected death in epilepsy being predominant (33%). People who had ever achieved 12\u2010month seizure freedom (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009317) had significantly lower SMRs than those who never did (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009293). Ever achieving seizure freedom was independently associated with a lower risk of all\u2010cause mortality (odds ratio [OR] = .30, 95% CI = .17\u2013.52) and epilepsy\u2010related death (OR = .29, 95% CI = .12\u2013.63). This protective effect was most pronounced in women, older adults, those with seizure onset during adulthood, and those without comorbidities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Mortality in this cohort remains more than twice that of the general population, with sudden death accounting for one third of cases. Achieving 1\u2010year seizure freedom even once during follow\u2010up substantially reduced mortality risk and altered cause\u2010of\u2010death distributions. This finding underscores seizure control as a practical and encouraging treatment goal in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70173","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:10:51Z","timestamp":1773011451000},"page":"2875-2889","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["One year of seizure freedom reduces premature death in people with epilepsy in rural China: A 10\u2010year cohort study"],"prefix":"10.1002","volume":"67","author":[{"given":"Xiaowen","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Neurology, Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders, Huashan Hospital Fudan University  Shanghai China"},{"name":"National Clinical Research Center for Aging and Medicine, Huashan Hospital Fudan University  Shanghai 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