Nontraumatic coma. Glasgow Coma Score and coma etiology as predictors of 2-week outcome

Ralph L Sacco, R. VanGool, J. P. Mohr, W. A. Hauser

Research output: Contribution to journalArticle

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Abstract

In 1987 and 1988, we carried out a prospective study of patients older than 10 years with nontraumatic coma in the intensive care units of Columbia-Presbyterian Medical Center, New York, NY. Of 188 patients with Glasgow Coma Scale (GCS) determinations within 72 hours, 61% were dead or in persistent coma by 2 weeks from onset. Age, sex, and ethnicity did not influence outcome. The 2-week outcome for patients with initial GCS of 3 to 5 was 14.8% awake; 85.2% were dead or in persistent coma. For the GCS 6 to 8 group, 53.1% were awake and 46.9% were dead or in persistent coma. Hypoxic or ischemic coma had the worst 2-week outcome (79%) dead or comatose); coma caused by metabolic disease or sepsis (68%), focal cerebral lesions (66%), and general cerebral diseases (55%) were intermediate, while drug-induced coma had a favorable outcome (27% dead or comatose). The independent predictors of 2-week outcome were the first GCS and drug-induced coma. The predicted probability of waking at 2 weeks was eight times better for drug-induced coma than other causes when GCS was held constant. Patients with an initial GCS score of 6 to 8 were seven times more likely to waken than those with a score of 3 to 5. The motor subscore alone was a significant independent predictor of 2-week outcome. Modification of coma score to include etiology may give more accurate predictions of 2-week outcome after nontraumatic coma.

Original languageEnglish
Pages (from-to)1181-1184
Number of pages4
JournalArchives of Neurology
Volume47
Issue number11
StatePublished - Jan 1 1990
Externally publishedYes

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Coma
Glasgow Coma Scale
Predictors
Etiology
Glasgow
Pharmaceutical Preparations
Metabolic Diseases
Drugs
Intensive Care Units
Sepsis
Prospective Studies

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Nontraumatic coma. Glasgow Coma Score and coma etiology as predictors of 2-week outcome. / Sacco, Ralph L; VanGool, R.; Mohr, J. P.; Hauser, W. A.

In: Archives of Neurology, Vol. 47, No. 11, 01.01.1990, p. 1181-1184.

Research output: Contribution to journalArticle

Sacco, RL, VanGool, R, Mohr, JP & Hauser, WA 1990, 'Nontraumatic coma. Glasgow Coma Score and coma etiology as predictors of 2-week outcome', Archives of Neurology, vol. 47, no. 11, pp. 1181-1184.
Sacco, Ralph L ; VanGool, R. ; Mohr, J. P. ; Hauser, W. A. / Nontraumatic coma. Glasgow Coma Score and coma etiology as predictors of 2-week outcome. In: Archives of Neurology. 1990 ; Vol. 47, No. 11. pp. 1181-1184.
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