Etiological, Clinical and Prognostic Characteristics of Comas in the Multipurpose Intensive Care Unit of The Zinder National Hospital

Author(s): MAGAGI Amadou, MAIKASSOUA Mamane, HASSAN Maman L BOUKARI MB, CHAIBOU MS, DADDY H, YAHAYA BN

Coma is a frequent diagnostic and therapeutic emergency. The aim of the study was to enumerate the etiologies of comas and to determine the prognosis of patients. It was a descriptive, cross-sectional study with prospective data collection from 1er May to 31 December 2021, i.e. a period of 8 months in the polyvalent intensive care unit of Zinder National Hospital. The parameters studied were sociodemographic aspects, admission conditions, clinical status on admission, paraclinical data, etiologies of comas, complications, patient outcome. During the study period, 830 patients were admitted, including 112 cases of coma, representing a frequency of 13.5%. The average age was 41.64±22.54 years, with extremes of 3 and 90 years. Males predominated, with a sex ratio of 1.5. Housewives were the most affected (33.9%). High blood pressure was the most frequent antecedent condition. In 66.9% of cases, onset was abrupt, and 47.3% of patients were admitted within 24 hours of coma. The Glasgow score on admission was between 6 and 8 in 47.3% of cases. Traumatic comas accounted for 36.4% of cases, followed by metabolic comas (24.8%) and vascular comas (22.2%). The average length of stay was 5 days. Overall mortality was 48.2%. Poor prognostic factors were: age over 60 (P<0.01), history of hypertension (P=0.02), respiratory distress (P<0.01), tachycardia (P<0.01), coma depth (P<0.01) and hospital stay of less than 3 days (P=0.02). Patients' prognosis depends on early and appropriate management.