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Prognosis in patients presenting with non-traumatic coma.
Sune Forsberg1, Jonas Höjer, Ulf Ludwigs
1Medical Intensive Care Unit, South Hospital, Stockholm, Sweden.
The Journal of Emergency Medicine
|June 15, 2010
Summary
Prognosis for non-traumatic coma is serious, with mortality varying by cause and initial consciousness level. Etiology and Glasgow Coma Scale score significantly impact survival outcomes in coma patients.
Area of Science:
- Neurology
- Emergency Medicine
- Critical Care
Background:
- Limited data exists on patient prognosis following coma.
- Understanding coma prognosis is crucial for clinical management.
Purpose of the Study:
- To investigate the acute and long-term prognosis of non-traumatic coma.
- To identify factors influencing survival in coma patients.
Main Methods:
- Prospective study of 865 adult patients admitted with Glasgow Coma Scale (GCS) score ≤10.
- Data collected on coma etiology and patient survival.
- 2-year follow-up for survival rates.
Main Results:
- Hospital mortality was 26.5%, with significant variation by etiology (e.g., 0.9% epilepsy to 71.7% circulatory failure).
- 2-year mortality reached 43.0%, ranging from 13.7% (poisoning) to 88.2% (malignancy).
- Lower GCS scores (3-6) were associated with higher mortality compared to GCS 7-10.
Conclusions:
- Non-traumatic coma carries a serious prognosis.
- Prognosis is heavily influenced by coma etiology and initial level of consciousness (GCS score).
- Incorporating coma etiology into grading may improve prognostic accuracy.
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