Non-traumatic Coma: Causes and Outcome of Adult Patients at University of Gondar Hospital, Northwest Ethiopia
Clinical Medicine Research
Volume 4, Issue 6, November 2015, Pages: 198-203
Received: Nov. 8, 2015; Accepted: Nov. 17, 2015; Published: Dec. 10, 2015
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Authors
Mohamed Abdulkadir Mohamed, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
Nebiyu Bekele, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
Ermias Diro, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
Ermias Shenkutie Greffie, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
Timothy Landers, College of Nursing, the Ohio State University, Ohio, U.S.A.
Habtewold Shibiru, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
Helen Gebremedhin, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
Murad Muhammed, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
Omer Abdu, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
Tesfaye Yesuf, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
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Abstract
Coma represents a serious, life-threatening medical condition which should be treated effectively. It is important to recognize the underlying causes of coma in order to provide timely medical treatment. There is dearth of data on causes of medical coma in adults in Africa. This research aimed at determining the cause and outcome of coma in University of Gondar Hospital. Methods: A prospective observational descriptive study was conducted from 01/01/2014 to 31/06/2014 G.C in University of Gondar Hospital. All consecutive non trauma patients admitted to the medical wards with a Glasgow Coma Scale of 8 or less were included. An interview administered questionnaire to patient attendants and neurologic examination were employed to collect data like sociodemographics and clinical features. All important laboratory tests and outcome data were documented at patient discharge. Verbal consent from attendants was taken. Data was entered to and analyzed using Epiinfo7. Result: A total of 53 patients constituting approximately 3.4% of the medical emergencies seen during the study period were included in the study. The most common cause of coma were diseases that cause no focal neurologic deficit (FND), occurring in 31 (58.5%) patients. Among the causes with non-localizing signs, the most common causes were intoxications, uremic and hepatic encephalopathies, occurring in 11 (20.8%), 7 (13.2%), and 5 (9.4%) of the patients, respectively. Organophosphate (malathion) poisoning was the most common agent of intoxication responsible for 9 patients out of 11. These were followed by diseases with FND and meningitis syndromes, occurring in 14 (26.4%) and 8 (15.1%) patients, respectively. Among the patients admitted with coma without FND, 17 (54.8%) of the patients died, 6 (19.3%) had disability and 8 (25.8%) patients were discharged with improvement. In contrast, among patients admitted with coma with FND, no patient was discharged with improvement, 7 (50%) died and 7 (50%) were disabled. Among patients admitted with meningitis syndrome, 4 (50%) died, 2 (25%) were disabled and 2 (25%) were discharged with improvement. Conclusion: Diseases presenting without focal neurologic deficit, including toxic and metabolic causes, are the most common causes of coma. Among these, the most common was malathion poisoning which is reversible with appropriate care. Meningitis syndrome was not found to be a prominent cause of coma. Medical coma, regardless of the etiology, was associated with high mortality rate.
Keywords
Focal Neurologic Deficit, Glasgow Coma Scale, Intoxication, Meningitis Syndrome
To cite this article
Mohamed Abdulkadir Mohamed, Nebiyu Bekele, Ermias Diro, Ermias Shenkutie Greffie, Timothy Landers, Habtewold Shibiru, Helen Gebremedhin, Murad Muhammed, Omer Abdu, Tesfaye Yesuf, Non-traumatic Coma: Causes and Outcome of Adult Patients at University of Gondar Hospital, Northwest Ethiopia, Clinical Medicine Research. Vol. 4, No. 6, 2015, pp. 198-203. doi: 10.11648/j.cmr.20150406.16
Copyright
Copyright © 2015 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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