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J Korean Soc Emerg Med > Volume 5(2); 1994 > Article
Journal of The Korean Society of Emergency Medicine 1994;5(2): 267-274.
CLINICAL ASSESSMENT IN CASES OF 193 COMATOSE PATIENTS
Hyung Seob Won, Ho Sung Chung, Cheol Wan Park, Keun Lee
Department of Emergency Medicine, Chung Ang Gil Hospital, lncheon, Korea
  Published online: December 31, 1994.
ABSTRACT
We performed a clinical analysis of 193 cases of comatose patients who visited to the emergency deparment of Chung Ang Gil Hospital from January 1993 to December 1993. The results were summarized as follows : 1. The incidence of comatose patients was 0.4% (193 cases of total 49061 patients). 2. There were 70 cases of traumatic coma(36.2%) and 123 cases of nontraumatic coma(63.7%) 3. The male to female ratio was 1 : 0.9, traumatic comatose patients were mainly male(26.4%) and nontraumatic comatose pateients mainly female(38.3%) 4. The highest incidence of traumatic comatose patients was among third decade patients(9.8%) and for nontraumatic comatose patients the highest incidence was among eighth decade patients(13.5%). 5. The month which was visited most frequently by comatose patients was August(14 % ) and both January and December were next with(12.4 %). The nontraumatic comatose patients had seasonal variations but the traumatic comatose patients had no concern with seasonal variation. 6. The cause of nontraumatic coma was mainly diffuse and metabolic brain dysfunction and it's incidence was 36.8% (71 cases of total 193 patients). 7. 16 traumatic coma patients(32.7%) had arterial hypoxia and 90 nontraumatic coma pa­ tients(44.4 %) had arterial hypoxia. So, It is important for prehospital care to prevent irriversible changes of brain function. 8. In long-term outcome, 24 cases of the nontraumatic patients(19.5 % ) were good-outcome out of a total 123 and 10 cases of the traumatic comatose patients(14.3%) were good-outcome out of a total of 70. We conclude that nontraumatic metabolic brain dysfunction is more common than other caus­es and the prognosis is much better. We must have interest in these cases. Prehospital care and rapid management in E.D. must be initiated to prevent irreversible neurological change.
Key words: traumatic coma, nontraumatic coma
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