Clinical Profile, Etiology and Outcome of Non Traumatic Coma in a Tertiary Care Centre

ABSTRACT

Introduction: Non Traumatic Coma is a very common presentation in emergency department. This study aimed at studying the various etiologies and factors determining outcome in these patients. Material and methods: This prospective observational cohort study was conducted in Goa Medical College and Hospital, over a period of six months on 100 patients of non traumatic coma. Outcome was recorded as either complete recovery, partial recovery with some disability or Death. Various factors affecting outcome were studied. Results: Among 100 cases of non traumatic coma studied, cerebrovascular accidents (33%) and metabolic causes (37%) constitute the major causes. Among cerebrovascular accidents, mortality among those with intracranial bleed was higher (66.6%) than that among cerebral infarct (46%). Metabolic, infective etiologies and drug overdose had better outcome. Patients with low GCS, abnormal respiratory pattern, and papilledema had worse outcome. Conclusion: Mortality was highest among patients with cerebrovascular accident. Patients with metabolic, infective and drug overdose had relatively better outcome. Other factors indicating poor outcome include low GCS, absent oculocephalic reflex, abnormal respiratory pattern and presence of papilledema