Title: Clinical predictors of mortality in non traumatic coma: A prospective observational study
Authors: Ashish Jain, HP Paliwal, Anchin Yadav
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.63
Abstract
Background: Coma developed during ongoing course of an illness commonly result in poor prognosis. Early prognostication is crutial for treatment decisions. This study has been conducted to ascertain the clinical predictors associated with mortality in nontraumatic coma in a tertiary institute .
Material and Methods: This is a prospective observational study in adults with clinically confirmed cases with GCS (glass coma scale) score < 8 in the ICU of tertiary hospital. Detailed study of vital parameters, neurological sign and GCS score were recorded. Precise etiology was determined with clinical signs and relevant investigations. Outcome was determined within 30 days of onset of coma.
Results: Total cases were 124 (76 males and 48 females). Stroke was predominant etiological factor (34.68%) followed by Infections(14.52%), CLD(10.48%),CKD (4.84%), toxic(1.61%) and others (25.81%) which included epilepsy , hypercarbia, malignancy/ metastasis and snake bite. overall one month mortality was 50 (40.32)%. Clinical factors of association with significant outcome were GCS, abnormal respiration, abnormal papillary size and reflex, Delayed presentation to Hospital, High MBP on admission and papilloedma.
Conclusion: The significant clinical predictors of nontraumatic coma in one month period in the study were GCS<5,Abnormal respiratory pattern, Pupillary signs including Papilloedma and High MBP.
Keywords- Nontraumatic coma, Clinical predictors, Etiology, Mortality, Prognosis.
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