title: Factors associated with death and predictors of 1-month mortality in nontraumatic coma in a tertiary hospital in Northwestern Nigeria.
abstract: BACKGROUND
  Coma occurring in the course of an illness ordinarily implies a poor prognosis and early prognostication is important for treatment decisions. The study was undertaken to study the factors associated with mortality in nontraumatic coma in a tertiary institution.
  
  
  METHODS
  In this prospective observational study, adults with clinically confirmed coma Glasgow coma scale (GCS) score of ≤8, admitted consecutively to the emergency unit of a tertiary hospital in Northwestern Nigeria over a period of 18 months were recruited. Vital parameters, severity of coma by GCS and neurological signs were recorded. The etiology of coma was determined on the basis of history, clinical examination, and laboratory investigations. Outcome was determined within 1 month of onset of coma by patients' death or survival.
  
  
  RESULTS
  A total of 194 patients (140 males and 54 females) were recruited with mean age was 53.7 ± 1.4. The predominant etiological factors were central nervous system (CNS) infections (28.9%), toxic and metabolic (28.9%), and stroke (23.7%). Overall, 1-month mortality was 49%. On univariate analysis, the factors that showed significant association with outcome were gender, blood pressure, GCS, breathing pattern, pupillary size, pupillary reaction, papiloedema, and abnormal posturing. Abnormal pupillary size, severe hypertension, and GCS score ≤5 were independent predictors of in-hospital 1-month mortality in nontraumatic coma.
  
  
  CONCLUSIONS
  The independent important predictors of nontraumatic 1-month coma mortality in a developing country setting were GCS ≤ 5, abnormal pupillary size, and severe hypertension.
authors.affiliation: Department of Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria.
authors.forename: Lukman Femi
authors.initials: LF
authors.lastname: Owolabi
authors.forename: Alhassan Datti
authors.initials: AD
authors.lastname: Mohammed
authors.forename: Mahmoud Muazu
authors.initials: MM
authors.lastname: Dalhat
authors.forename: Aliyu
authors.initials: A
authors.lastname: Ibrahim
authors.forename: Salisu
authors.initials: S
authors.lastname: Aliyu
authors.forename: Desola Shakirat
authors.initials: DS
authors.lastname: Owolabi
keywords: Coma; mortality; predictors