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Journal of Clinical and Applied Neurosciences                            Volume 1; Issue 1                                   Jan-Jun 2015
ORIGINAL ARTICLE
Non-traumatic coma: causes and outcome in a Nigerian tertiary hospital
Paul O NWANI, Maduaburochukwu C NWOSU

AFFILIATION
Neurology Unit
Department of Medicine
Nnamdi Azikiwe University
Teaching Hospital, Nnewi
Anambra State, NIGERIA

CORRESPONDING AUTHOR
Paul O NWANI
Department of Medicine
Nnamdi Azikiwe University
Teaching Hospital
P.M.B 5025 Nnewi
Anambra State, NIGERIA




E-mail: paul.nwani@yahoo.com
Phone: +2347082191962             




DISCLOSURES: NONE
ABSTRACT
Background:
Non-traumatic coma arising from primary neurological or non-neurological diseases is common, and the outcome is often poor. Data on non-traumatic coma among adults is lacking in South-East Nigeria.
Objective: To determine the causes and outcome of non-traumatic coma among adult medical in-patients who presented with coma.
Methodology: A retrospective study of the medical records of patients admitted in the medical wards of a Nigerian tertiary hospital on account of non-traumatic coma over a twenty-four month period.
Results: Non-traumatic coma accounted for 7.4% of the 1507 medical admissions (n=111/1507) during the period under review. There were 71 (64%) females and 40 (36%) males with a mean age of 57.7 23.2years and age range of 20 to 89years.  Stroke accounted for 52.2% (n=58) of non-traumatic coma while metabolic causes and infections accounted for 18.9% (n=21) and 18% (n=20), respectively. Infectious causes peaked in those below 50years of age while stroke and metabolic causes peaked in those 50years and above. Forty-two (37.9%) of the patients that died presented with Glasgow Coma Score (GCS) <6. The difference in the outcome between those with GCS <6 and those with GCS =6 was statistically significant (
?2 = 16.799, p=0.0001).
Conclusion: Acute stroke accounted for most cases of non-traumatic coma followed by metabolic and infective causes. Even in non-traumatic coma the presenting GCS can be a valuable tool for prognostication.

Keywords: Adult in-patients, infections, metabolic, South-East Nigeria, stroke.

Received: 26th January, 2015                                                                            Accepted: 18th February, 2015