E-ISSN 2367-699X | ISSN 2367-7414
 

Original Research

Online Publishing Date:
06 / 01 / 2023

 


Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia

Adel Hamed Elbaih, Yasir Abdulmohsen Alrusayni, Mohammad Jawad Alamgir, Adel Nabbaa Alrashdi, Fahad Hamoud Alrashdi, Monira Taha Ismail.


Abstract
Background:
Disorders of consciousness including coma can be caused by a wide variety of etiologies affecting the central nervous system. Severity of coma may vary according to the causes of coma and patient’s characteristics.
Objective:
To determine frequency of major causes of coma patients presented to Emergency Department (ED) of tertiary care hospitals in Qassim region of Saudi Arabia.
Methods:
This retrospective audit study consisting of cases of coma, presented with impaired conscious level of any age and either gender admitted through ED of tertiary care hospitals in X region of Saudi Arabia over past 2 years. Patients with transient impairment of conscious level, pregnant women, referred cases of multiple organ failure and no clear etiological diagnosis on discharge were excluded from the study. After ethical approval, the data of the patients were collected retrospectively from the medical records on structured Proforma (Annexure-1).
Results:
Out of 422 patients of coma, 96 (22.7%) were observed with severely reduced GCS (≤8 score). About 2/3rd of patients had non-traumatic causes of coma (NTC) out of this cerebral infarction (16.4%) and metabolic brain dysfunction (15.6%) were the major causes in age group >50 years. The most frequent single cause of altered mental status was traumatic brain injury (TBI) in 31% of cases with age group less the 40 years most affected 68%. Regarding the localization of coma, we observed; Diffuse brain dysfunction in 40% (n=169), Supra tentorial location in 44.8% (N=189) and infra tentorial localization in 15.2% (n=64) of cases, however the severe coma causes in older patients (>60 years) were infratentorial stroke, CNS infection, brain metastasis and brain anoxia (p<0.001).
Conclusions:
The leading cause of coma in our study in the age group less than 40 years was TBI about 68% of cases, but highly significant association of severe coma was found with older patients (>60 years), infratentorial stroke, CNS infection, brain metastasis and brain anoxia.

Key words: Coma, etiology, frequency, non-traumatic coma, traumatic brain injury, coma localization.


 
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How to Cite this Article
Pubmed Style

Elbaih AH, Alrusayni YA, Alamgir MJ, Alrashdi AN, Alrashdi FH, Ismail MT. Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia. Int J Surg Med. 2023; 9(1): 10-14. doi:10.5455/ijsm.136-1663664449


Web Style

Elbaih AH, Alrusayni YA, Alamgir MJ, Alrashdi AN, Alrashdi FH, Ismail MT. Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia. https://www.ejos.org/?mno=115780 [Access: February 20, 2024]. doi:10.5455/ijsm.136-1663664449


AMA (American Medical Association) Style

Elbaih AH, Alrusayni YA, Alamgir MJ, Alrashdi AN, Alrashdi FH, Ismail MT. Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia. Int J Surg Med. 2023; 9(1): 10-14. doi:10.5455/ijsm.136-1663664449



Vancouver/ICMJE Style

Elbaih AH, Alrusayni YA, Alamgir MJ, Alrashdi AN, Alrashdi FH, Ismail MT. Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia. Int J Surg Med. (2023), [cited February 20, 2024]; 9(1): 10-14. doi:10.5455/ijsm.136-1663664449



Harvard Style

Elbaih, A. H., Alrusayni, . Y. A., Alamgir, . M. J., Alrashdi, . A. N., Alrashdi, . F. H. & Ismail, . M. T. (2023) Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia. Int J Surg Med, 9 (1), 10-14. doi:10.5455/ijsm.136-1663664449



Turabian Style

Elbaih, Adel Hamed, Yasir Abdulmohsen Alrusayni, Mohammad Jawad Alamgir, Adel Nabbaa Alrashdi, Fahad Hamoud Alrashdi, and Monira Taha Ismail. 2023. Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia. International Journal of Surgery and Medicine, 9 (1), 10-14. doi:10.5455/ijsm.136-1663664449



Chicago Style

Elbaih, Adel Hamed, Yasir Abdulmohsen Alrusayni, Mohammad Jawad Alamgir, Adel Nabbaa Alrashdi, Fahad Hamoud Alrashdi, and Monira Taha Ismail. "Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia." International Journal of Surgery and Medicine 9 (2023), 10-14. doi:10.5455/ijsm.136-1663664449



MLA (The Modern Language Association) Style

Elbaih, Adel Hamed, Yasir Abdulmohsen Alrusayni, Mohammad Jawad Alamgir, Adel Nabbaa Alrashdi, Fahad Hamoud Alrashdi, and Monira Taha Ismail. "Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia." International Journal of Surgery and Medicine 9.1 (2023), 10-14. Print. doi:10.5455/ijsm.136-1663664449



APA (American Psychological Association) Style

Elbaih, A. H., Alrusayni, . Y. A., Alamgir, . M. J., Alrashdi, . A. N., Alrashdi, . F. H. & Ismail, . M. T. (2023) Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia. International Journal of Surgery and Medicine, 9 (1), 10-14. doi:10.5455/ijsm.136-1663664449