Evaluation of Coma in Non Head Injury Cases

INTRODUCTION: Comatose patients presenting to the emergency room is always a challenge to the diagnosing physician.Prompt diagnosis and management is needed to save the life and it also decides the outcome and prognosis.In our study,we are aiming to find out the causes of trauma in non head injury cases in our hospital. STUDY CENTRE: MGM Govt. Hospital attached to K A P Viswanatham Govt. Medical College, Trichy. STUDY PERIOD: November 2014-August 2015. STUDY DEGIGN: Descriptive study. MATERIALS AND METHODS: Patients aged between 12-80 years presenting to emergency department in our hospital due to non traumatic causes were evaluated using history, examination,various coma scales,investigations and imaging modalities and the causes were found out,stastical analysis was done and conclusions were made based on all the findings. CONCLUSION: The most common cause of non traumatic Coma in adults in our study is non structural brain disease. The predominant cause of coma was toxic and metabolic causes,cerebrovascular accident, infections. CT brain showed abnormal finding in concordance with cause of coma in structural brain disease whereas CT brain did not show any demonstrable abnormality in most of the non structural causes of coma. Dyslipidemia was a statistically significant risk factor for diabetes, hypetension and CAD cases. Patients who regained some neurologic activity after 72 hours were mostly CVA-ischemic stroke and those with metabolic causes for coma.Low coma scores at admission showed poorer outcomes. FOUR Score Coma Scale is a very good tool in assessing the short term prognosis of comatose patients,especially after 24 hours when it directly correlates with mortality