Prognosis of non traumatic coma: The role of some socio-economic factors on its outcome in Ibadan, Nigeria

Obiako, OR; Ogunniyi, A; Anyebe, EE

doi:10.4103/1596-3519.56240

Cited by 11 publications

(16 citation statements)

References 19 publications

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“…This figure, which must be viewed in the context of limited investigative facilities, is comparable to that reported in similar studies in some other developing countries. [5,28] The mortality rate of 49% recorded in the present study, although comparable to report from other places, [5,11,29] was less than 76% previously reported in Ibadan, [17] southwestern Nigeria. This difference could be ascribed to a higher proportion of coma from metabolic encephalopathy which arguably has a better recovery rate in this study.…”

Section: Discussionsupporting

confidence: 85%

“…[4,15,16] This male preponderance may portray the belief that males have more risky or disease promoting lifestyles than females and so are more likely to fall sick and present to hospital. [17] The predominant etiological factors were infections, toxic and metabolic causes and stroke. The relative frequency of various causes of coma in our patients was similar to previous report outside Nigeria in spite of the geographic and technological differences.…”

Section: Discussionmentioning

confidence: 99%

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Etiology and outcome of medical coma in a tertiary hospital in Northwestern Nigeria

Lukman¹,

Datti²,

Geoffrey³

et al. 2012

Ann Nigerian Med

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Etiology and outcome of medical coma in a tertiary hospital in Northwestern Nigeria

Lukman¹,

Datti²,

Geoffrey³

et al. 2012

Ann Nigerian Med

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“…The mortality rate of 49% recorded in the present study, although comparable to report from other places,[478] was less than 76% previously reported in Ibadan,[9] southwestern Nigeria. This difference could be ascribed to a higher proportion of coma from metabolic encephalopathy with a better recovery rate in our study.…”

Section: Discussionsupporting

confidence: 84%

“…Previous reports on effect of age on medical coma in children and adults revealed conflicting findings. [915] Nonetheless, our finding suggests that the prognosis for recovery from nontraumatic cerebral insult as one ages may not necessarily be a function of the aged brain, but the type of insult that occurs frequently in each age group.…”

Section: Discussionmentioning

confidence: 82%

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Factors associated with death and predictors of 1-month mortality in nontraumatic coma in a tertiary hospital in Northwestern Nigeria

Owolabi¹,

Mohammed²,

Dalhat³

et al. 2013

Indian Journal of Critical Care Medicine

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Background:Coma occurring in the course of an illness ordinarily implies a poor prognosis and early prognostication is important for treatment decisions. The study was undertaken to study the factors associated with mortality in nontraumatic coma in a tertiary institution.Materials and Methods:In this prospective observational study, adults with clinically confirmed coma Glasgow coma scale (GCS) score of ≤8, admitted consecutively to the emergency unit of a tertiary hospital in Northwestern Nigeria over a period of 18 months were recruited. Vital parameters, severity of coma by GCS and neurological signs were recorded. The etiology of coma was determined on the basis of history, clinical examination, and laboratory investigations. Outcome was determined within 1 month of onset of coma by patients’ death or survival.Results:A total of 194 patients (140 males and 54 females) were recruited with mean age was 53.7 ± 1.4. The predominant etiological factors were central nervous system (CNS) infections (28.9%), toxic and metabolic (28.9%), and stroke (23.7%). Overall, 1-month mortality was 49%. On univariate analysis, the factors that showed significant association with outcome were gender, blood pressure, GCS, breathing pattern, pupillary size, pupillary reaction, papiloedema, and abnormal posturing. Abnormal pupillary size, severe hypertension, and GCS score ≤5 were independent predictors of in-hospital 1-month mortality in nontraumatic coma.Conclusion:The independent important predictors of nontraumatic 1-month coma mortality in a developing country setting were GCS ≤ 5, abnormal pupillary size, and severe hypertension.

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Comparative etiological analysis of critical patients presenting to the emergency department with altered consciousness across age groups: A prospective observational study

Yildirim,

Armagan,

Kose

et al. 2024

Hong Kong j. emerg. med.

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IntroductionThe aim of our study is to assess the relationship between altered consciousness in patients presenting to the emergency department (ED) without a history of trauma and the physiological changes associated with aging. Additionally, we aim to compare diagnostic differences between patients under the age of 65 and those aged 65 and above.MethodsThis prospective study was conducted at the ED of Uludağ University Medical Faculty Hospital over a 1‐year period from December 2012 to November 2013. Patients aged 18 and above presenting with non‐traumatic altered consciousness were included, and they were categorized into two groups based on age: <65 years and ≥65 years. Comparison between age groups included gender, seasonal presentation, vital signs, consciousness level, Glasgow Coma Scale (GCS) score, requested consultations, diagnoses, and outcomes.ResultsOut of 646 patients, 312 (48%) were female, and 334 (52%) were male, with a mean age of 64.9 ± 16.4 years. The highest number of admissions for altered consciousness occurred during the summer season (n = 200, 31%). In the 65 and above age group, a statistically significant elevation was found in the mean systolic blood pressure (p < 0.05). In neurological diagnoses, cerebrovascular events were observed most frequently, while in non‐neurological diagnoses, endocrine/metabolic diseases were more common. It was observed that GCS scores were lower in neurological diagnoses (p = 0.020). Discharges were more frequent in the under 65 age group, with a statistically significant difference (p < 0.05). It was found that the mortality rate was higher in non‐neurological diagnoses, and this was statistically significant (p < 0.001).ConclusionWhen determining the cause of altered consciousness in patients with such symptoms, a comprehensive understanding of physiological changes in elderly individuals is crucial. While high blood pressure may indicate neurological diagnoses, tachycardia, tachypnea, and fever may suggest non‐neurological causes.

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Prognosis of non traumatic coma: The role of some socio-economic factors on its outcome in Ibadan, Nigeria

Cited by 11 publications

References 19 publications

Etiology and outcome of medical coma in a tertiary hospital in Northwestern Nigeria

Etiology and outcome of medical coma in a tertiary hospital in Northwestern Nigeria

Factors associated with death and predictors of 1-month mortality in nontraumatic coma in a tertiary hospital in Northwestern Nigeria

Comparative etiological analysis of critical patients presenting to the emergency department with altered consciousness across age groups: A prospective observational study

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