 |
|
Nontraumatic ComaGlasgow Coma Score and Coma Etiology as Predictors of 2-Week Outcome
Ralph L. Sacco, MD;
R. VanGool, MD;
J. P. Mohr, MD;
W. A. Hauser, MD
Arch Neurol. 1990;47(11):1181-1184.
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.
Author Affiliations
From the Neurological Institute (Drs Sacco, Mohr, and Hauser) and Sergievsky Center of Neuroepidemiology, Columbia-Presbyterian Medical Center (Drs VanGool and Hauser), New York, NY.
Footnotes
Accepted for publication April 23, 1990.
Reprint requests to the Neurological Institute, 710 W 168th St, New York, NY 10032 (Dr Sacco).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Post-Cardiac Arrest Syndrome: Epidemiology, Pathophysiology, Treatment, and Prognostication A Consensus Statement From the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa); the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; and the Stroke Council
Neumar et al.
Circulation 2008;118:2452-2483.
FULL TEXT
Is This Patient Dead, Vegetative, or Severely Neurologically Impaired?: Assessing Outcome for Comatose Survivors of Cardiac Arrest
Booth et al.
JAMA 2004;291:870-879.
ABSTRACT
| FULL TEXT
MRI identification of early white matter injury in anoxic-ischemic encephalopathy
Korn-Lubetzki et al.
Neurology 2001;57:745-745.
FULL TEXT
Somatosensory potentials, CSF creatine kinase BB activity, and awakening after cardiac arrest
Korn-Lubetzki et al.
Neurology 2000;55:735-742.
FULL TEXT
Identification of Comatose Patients at High Risk for Death or Severe Disability
Hamel et al.
JAMA 1995;273:1842-1848.
ABSTRACT
End-Stage Alzheimer's Disease: Glasgow Coma Scale and the Neurologic Examination
Benesch et al.
Arch Neurol 1993;50:1309-1315.
ABSTRACT
P300 Auditory Event-Related Potentials in Nontraumatic Coma: Association With Glasgow Coma Score and Awakening
Gott et al.
Arch Neurol 1991;48:1267-1270.
ABSTRACT
Biased Estimates of Expected Acute Myocardial Infarction Mortality Using Medis-Groups Admission Severity Groups
Blumberg
JAMA 1991;265:2965-2970.
ABSTRACT
|
