Gams Massi Daniel, Kedonkwo Mbogne Adonis Herman, Siysi Verla Vincent, Metogo Mbengono Junette Arlette, Magnerou Annick Mélanie, Bila Lamou Eric Gueumekane, Sini Victor, Mbonda Chimi Paul Cédric, Doumbe Jacques, Kuate Tegueu Callixte, Yacouba Mapoure Njankouo
Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Douala General Hospital, Douala, Cameroon.
Afr J Emerg Med. 2024 Sep;14(3):179-185. doi: 10.1016/j.afjem.2024.06.003. Epub 2024 Jul 5.
Coma is a medical emergency, and optimal management, especially in a resource-poor setting, depends on knowledge of its aetiology and predictors of outcome. This study aimed to provide hospital-based data on the prevalence, etiology, and outcome of non traumatic coma (NTC) in adults at a tertiary level in Cameroon.
A three year retrospective cohort study of medical records of patients aged 18 years and above, who presented in coma of non-traumatic origin at a Cameroon emergency department (ED) was conducted. Data related to sociodemographic, clinical findings, investigations, etiology of the coma, and outcomes were collected.
A total of 408 patients were recruited, 214 (52.5 %) were males. The mean age was 55.9 ± 16.6 years. NTC accounted for 2.2 % of all consultations at the ED during the period of study. Stroke (29.6 %), infections (19.8 %), and metabolic disorders (12.6 %) were the most frequent cause of NTC. Etiology was unknown in 23.3 % of our participants. The in-hospital mortality was 66.4 %. Duration of hospitalization ≤ 3 days, GCS 〈 6, serum creatinine level 〉 13 mg/L, and administration of adrenergic drugs were predictors of mortality. Overall survival rate was 44.3 % after 5 days of admission.
Non-traumatic coma had various aetiologies. Stroke accounted for almost one third of cases. About three out of five patients died in hospital. Deep coma, high serum creatinine level, short hospital stay and administration of adrenergic medications were independent predictors of mortality.
昏迷是一种医疗急症，最佳治疗方案，尤其是在资源匮乏地区，取决于对其病因及预后预测因素的了解。本研究旨在提供喀麦隆一家三级医院中成人非创伤性昏迷（NTC）的患病率、病因及预后的基于医院的数据。
对喀麦隆一家急诊科18岁及以上非创伤性昏迷患者的病历进行了为期三年的回顾性队列研究。收集了与社会人口统计学、临床发现、检查、昏迷病因及预后相关的数据。
共招募了408名患者，其中214名（52.5%）为男性。平均年龄为55.9±16.6岁。在研究期间，NTC占急诊科所有会诊病例的2.2%。中风（29.6%）、感染（19.8%）和代谢紊乱（12.6%）是NTC最常见的病因。23.3%的参与者病因不明。住院死亡率为66.4%。住院时间≤3天、格拉斯哥昏迷评分（GCS）〈6、血清肌酐水平〉13mg/L及使用肾上腺素能药物是死亡率的预测因素。入院5天后总体生存率为44.3%。
非创伤性昏迷病因多样。中风约占病例的三分之一。约五分之三的患者在医院死亡。深度昏迷、高血清肌酐水平、住院时间短及使用肾上腺素能药物是死亡率的独立预测因素。
