ASSESMENT OF OUTCOME IN COMA PATIENTS IN RELATION TO ETIOLOGY

Dr .I.S.S.V.PRASADA MURTHY RAJU; Dr. THRILOK CHANDER; Dr. K.SPOORTHY

Volume : V, Issue : IX, September - 2016

ASSESMENT OF OUTCOME IN COMA PATIENTS IN RELATION TO ETIOLOGY

Dr . I. S. S. V. Prasada Murthy Raju, Dr. Thrilok Chander, Dr. K. Spoorthy

Abstract :

BACKGROUND:- The comatose patient is one of the common neurological problems that an emergency physician encounters in the emergency room. Due to the heterogeneity of the causes of non-traumatic coma1,2, prediction of outcome in these patients is difficult and unfortunately no clinical, laboratory or electro-physiological parameter exists to determine their outcome. Early recognition of a comatose patient3,4 ,followed by timely and appropriate treatment strategies have been shown to significantly reduce mortality . . OBJECTIVES: -1.to study the clinical profile of patients with non traumatic coma (NTC) 2 To know the outcome of these patients with respect to etiology and GCS score .STUDY DESIGN: prospective cross sectional observational study. MATERIALS & METHODS: 100 patients admitted in the emergency department of Gandhi hospital during October 2014 to October 2015 ,who were diagnosed as nontraumatic coma and evaluated by detailed history and clinical examination were considered in this study. Statistical methods: The observations and data were analyzed in the statistical package social sciences (SPSS) trial version 11 by Chi-square and Fisher Exact test has been used to find the significance of proportions of outcome with various demographic, etiological and neurological factors.The level of significance was set at P<0.05. Results: Intracranial causes (52%) formed the majority of cases followed by metabolic causes (32%) and drug/poisoning induced (12%). 14 different etiologies were observed causing non-traumatic coma in the present study. Mortality was highest in intracranial causes group, whereas 4 cases survived among 5 cases of coma due to drug overdose or poisoning. There were 18 cases of neuro-infection leading to coma out of which 4 cases were diagnosed to have tubercular meningitis, of which two were coinfected with HIV virus Conclusions: 1. Results of this study indicate that an early indication of prognosis can be made from the combination of the GCS and etiologic subtype of coma. Knowing the predicted probability of outcome may assist in clinical therapeutic decisions