OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and OutcomeComa: Causes and Outcomes of Adult Adult Adult Adult Adult Adult Patients Patients Patients Patients Patients Patients Patients Patients Patients at University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar University of Gondar HospitalHospitalHospitalHospitalHospitalHospitalHospitalHospital NorthNorthNorthNorthNorth-West West West West West EthiopiaEthiopiaEthiopiaEthiopiaEthiopiaEthiopiaEthiopiaEthiopia

Abstract

Introduction: 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. Therefore, the aim of this study is to determine the causes and outcomes coma. Objective: It is to determine the causes and outcomes of coma in University of Gondar Hospital medical wards. Method: A prospective observational descriptive study was conducted from 01/01/2014 to 31/06/2014 G.C in University of Gondar Hospital. All patients admitted with a Glasgow Coma Scale of 8 or less were included. Sociodemographic, clinical and laboratory data and treatment outcome were collected using a structured questionnaire and analyzed using EPIinfo®. 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, uremia and hepatic encephalopathies, occurring in 11 (20.8%), 7 (13.2%), and 5 (9.4%) of the patients, respectively. 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%) of patients were discharged with improvement. In contrast, 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. Medical coma, regardless of the etiology, was associated with high mortality rate.