Volume 14 Supplement 1

30th International Symposium on Intensive Care and Emergency Medicine

Open Access

Prognosis in patients presenting with nontraumatic coma

  • S Forsberg1,
  • J Höjer1 and
  • U Ludwigs1
Critical Care201014(Suppl 1):P333

https://doi.org/10.1186/cc8565

Published: 1 March 2010

Introduction

Studies of patients presenting with coma are limited and little is known about the prognosis of these cases [13]. The aim of this study was to investigate the acute and long-term prognosis after an episode of nontraumatic coma.

Methods

Adults admitted consecutively to an emergency department in Stockholm, Sweden between February 2003 and May 2005 with a Glasgow Coma Scale (GCS) score of 10 or below were enrolled prospectively. All available data were used to explore the cause of the impaired consciousness on admission. Patients surviving hospitalization were followed up for 2 years regarding survival.

Results

The final study population of 865 patients had the following eight different coma etiologies: poisoning (n = 329), stroke (n = 213), epilepsy (n = 113), circulatory failure (n = 60), infection (n = 56), metabolic disorder (n = 44), respiratory insufficiency (n = 33), and intracranial malignancy (n = 17). The hospital mortality rate among the 865 patients was 26.5%, varying from 0.9% for epilepsy to 71.7% for circulatory failure. The accumulated total 2-year mortality rate was 43.0%, varying from 13.7% for poisoning to 88.2% for malignancy. The level of consciousness on admission also influenced the prognosis: a GCS score of 3 to 6.

Conclusions

The prognosis in patients presenting with nontraumatic coma is serious and depends largely both on the level of consciousness on admission and on the etiology of the coma. Adding the suspected coma etiology to the routine coma grading of these emergencies may more accurately predict their prognosis.

Authors’ Affiliations

(1)
Karolinska Institute

References

  1. Martikainen K, Seppä K, Viita P, Rajala S, Laippala P, Keränen T: Transient loss of consciousness as reason for admission to primary health care emergency room. Scand J Prim Health Care 2003, 21: 61-64. 10.1080/02834310000591View ArticleGoogle Scholar
  2. Kanich W, Brady WJ, Huff JS, Perron AD, Holstege C, Lindbeck G, Carter CT: Altered mental status: evaluation and etiology in the ED. Am J Emerg Med 2002, 20: 613-617. 10.1053/ajem.2002.35464View ArticleGoogle Scholar
  3. Levy DE, Bates D, Caronna JJ, et al.: Prognosis in nontraumatic coma. Ann Intern Med 1981, 94: 293-301.View ArticleGoogle Scholar

Copyright

© BioMed Central Ltd. 2010

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