أسباب السبات غير الرضية وإنذاره عند المرضى المقبولين في مشفى الأسد ومشفى تشرين الجامعيين

Abstract

Introduction : Non – traumatic coma is a common cause of admission in emergency unit, medical wards and intensive care unit. A better understanding of causes and outcome is key to planning and improving rational approach to the management of this condition . Aim : The study was undertaken to evaluate common etiologies and outcome of non- traumatic coma among adult patients in Tishreen and Al-Assad University Hospitals in Lattakia , Syria. Materials and Methods : In this prospective study, adult patients with coma admitted to Intensive Care Units And Division of Neurology of the Tishreen and Al-Assad University Hospitals ,during the period between July 2016 and July 2017 , were consecutively recruited. Etiology of coma was determined on the basis of history, clinical examination, relevant laboratory and radiological investigations. Outcome was determined within 30 days of onset of coma . Results : Total cases were 80 (38 males and 42 females). Stroke was predominant etiological factor (38.75%) followed by anoxic brain injury (21.25%) , intracranial infections (17.5%) , and status epilepticus (7.5%) . Mortality was 55 (68.75%)% . Clinical factors of association with significant outcome were brainstem reflexes after 24 hours of admission , GCS in 24 hours of admission , patient's age , drug overdose , infectious shock , status epilepticus , and the need for mechanical ventilation emergently (causes other than airway protection) . Conclusion : Structural causes are more common than metabolic , mortality among patients with nontraumatic coma is significantly associated with older ages , absence of brainstem reflexe after 24 hours of admission ,GCS 6 خلال 24 ساعة من القبول, حالات التسمم الدوائي , الصدمة الانتانية , الحالة الصرعية و الحاجة إلى استخدام التهوية الآلية بشكل إسعافي .